Purpose To determine optimal management strategies for the treatment of mandibular AVM.
Materials and Methods Twelve patients (9 females, 3 males), age 9–14; mean age 10, underwent endovascular therapy to treat their mandibular AVMs. Nine patients had distinct intraosseous AVMs. Three had multiple facial and intra-maxillary AVMs requiring treatment. Outside institutions recommended massive hemifacial resections in these patients. Four patients had prior PVA and gel foam embolisation, one patient had a lip graft, one had prior mandible surgery, all that had failed.
Results All twelve patients have demonstrated MR and angiographic cure of their AVMs. One patient’s therapy is not completed and is on-going. The follow-up is 11 months-41 months, with a mean follow-up of 29 months. No complications were noted.
Conclusions Endovascular approaches to manage mandibular AVM can be curative. The intraosseous variety is largely a fistula between artery and vein within the bone. All respond well to endovascular ethanol therapy alone. Surgery was not required in any patient. Surprisingly, no complications were encountered in this patient series. Long-term cures are noted in this patient series with endovascular approaches alone. No massive surgical resections in any patient, even in patients with multiple AVMs of the soft tissues, mandible and maxilla, were required to effect cures.
Disclosures W. Yakes: None.
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