Endovascular treatment of an intraosseous arteriovenous malformation of the mandible in a child. A case Report

P Cariati,I Martinez-Lara,Ma Julia-Martinez,M Perez-De Perceval-Tara,D Sanchez-Lopez,Ab Marin-Fernandez

doi:10.4317/jced.54550

Abstract

The modern application of interventional radiology techniques is revolutionizing the treatment of the vascular malformations of the head and neck. In fact, the morbidity related with the surgical extirpation of the malformation might be drastically reduced with the use of an endovascular approach. The present report describes the case of a 11 years old male affected by a large intraosseous arteriovenous malformation of the mandible. The coil embolization of the main drainage vein caused the spontaneous regression of the lesion and avoided a mutilating surgery and severe psychological sequels. A multidisciplinary approach of these case is mandatory. A careful clinical and radiological study of the patient is essential for a proper management. The choice of the treatment should be based on the location and extension of the malformation, age of the patient, experience with endovascular techniques and clinic. Key words:Endovacualr approach, intraosseous arteriovenous malformation, head and neck, child.

Highlights

Arteriovenous malformations (AVMs) are uncommon and congenital vascular malformations representing only 1.5% of all vascular anomalies
Endovascular techniques are currently considered the treatment of choice, and are often combined with the surgical resection of the lesion
The main aim of the present report is to show the brilliant results obtained with radiologically assisted embolization in the treatment of a large high-flow intraosseous arteriovenous malformation

Summary

Introduction

Arteriovenous malformations (AVMs) are uncommon and congenital vascular malformations representing only 1.5% of all vascular anomalies. In 1996, the International Society for the Study of Vascular Anomalies (ISSVA) adopted and reviewed the classification created by Mulliken and Glowacki in 1982. They proposed the division of these anomalies in two groups: 1) tumors and 2) malformations. The vascular malformations could be divided into low-flow (capillary, venous or lymphatic) and fast flow malformations (arterial malformation and arteriovenous fistula) [2,3]. These lesions are congenital, they usually grow during adolescence and adulthood. Endovascular techniques are currently considered the treatment of choice, and are often combined with the surgical resection of the lesion

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Conclusion