Direct Nidal Ethyl Vinyl Alcohol Copolymer Embolization With Flow Reduction Techniques as a Primary Treatment for Intraosseous Mandibular Arteriolovenous Malformations

Abstract

Intraosseous mandibular arteriovenous malformations are uncommon and can be an important cause of major oral bleeding if undiagnosed, especially in the setting of loose dentition. Catheter angiography and embolization has been reported with good success using several agents. This report describes the use of direct (percutaneous/intraoral) intranidal ethylene-vinyl alcohol copolymer injection with arterial flow reduction to treat 2 intraosseous mandibular arteriolovenous malformations without complication. This treatment in both cases resulted in a stable ethylene-vinyl alcohol copolymer cast, fixed dentition, and remodeling of the mandible to a normal architecture with clinical and imaging stability over a long follow-up period.