Intervention Radiology, Medanta Hospital, Lucknow, India.
Radiodiagnosis, Medanta Lucknow, Lucknow, India
BMJ Case Rep. 2023 Jan 24;16(1):e251589. doi: 10.1136/bcr-2022-251589.
Mandibular arteriovenous malformations (AVMs) are rare lesions which can present with life-threatening haemorrhage. Endovascular embolisation can be life saving for these patients. We discuss a patient of mandibular AVM, who initially presented with reports of massive oral bleeding. The lesion was only partially embolised via transarterial route, as the nidus could not be penetrated completely. In view of rebleeding within 72 hours from the same site, a second embolisation procedure was done via combined, transarterial and transvenous approaches. Coils and onyx were used as embolising agents. Complete embolisation was achieved via combined approach. No further bleeding episodes were seen at 1-year follow-up. Endovascular embolisation of mandibular AVMs can be technically challenging and, hence, a sound knowledge of the anatomy as well as the possible modification of technique is essential to achieve complete obliteration of the lesion and to maximise the benefit of embolisation and to avoid major radical surgery.
下颌动静脉畸形（AVM）是一种罕见的病变，可导致危及生命的出血。血管内栓塞术可以为这些患者提供救命治疗。我们讨论了一位下颌 AVM 患者，他最初表现为大量口腔出血的报告。该病变仅通过动脉途径部分栓塞，因为病灶不能完全穿透。由于同一部位在 72 小时内再次出血，因此通过联合经动脉和经静脉途径进行了第二次栓塞治疗。使用线圈和onyx 作为栓塞剂。通过联合途径实现了完全栓塞。在 1 年随访时，未再出现出血发作。下颌 AVM 的血管内栓塞术在技术上具有挑战性，因此，为了实现病变的完全闭塞，最大限度地提高栓塞的益处并避免主要的根治性手术，需要对解剖结构有深入的了解，并对技术进行适当的修改。
