AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on March 6, 2009
doi: 10.3174/ajnr.A1539
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Ethanol Embolization of Arteriovenous Malformations of the Mandible

X.D. Fana, L.X. Sub, J.W. Zhengb, L.Z. Zhenga and Z.Y. Zhangb

a Department of Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
b Departments of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China


Figure 1
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  		Fig 1. Axial CT scan demonstrated unilocular radiolucency (arrow) in the mandible with an expanded mental foramen (arrowhead).


Figure 2
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  		Fig 2. A, The lateral view of the angiogram of the inferior alveolar artery in the left side demonstrated varix formation (arrow) and expansion of the jugular vein (arrowhead). B, The varix (arrow) and expansion of the jugular vein (arrowhead) were noted on the posteroanterior view of the angiogram of the inferior alveolar artery.


Figure 3
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  		Fig 3. The position of the 16G needle into the varix (arrow) was verified on the venogram as the demonstration of the drainage vein (arrowhead).


Figure 4
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  		Fig 4. Venogram through the needle revealed some residual arteriovenous shunt surgery around the coils (arrow), and absolute ethanol was injected to obliterate the residual AVMs through the needle after release of the coils.


Figure 5
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  		Fig 5. The control arteriogram of the inferior alveolar artery demonstrated the remaining filling of the mandibular nidus, and additional absolute ethanol was injected via a transcatheter approach.


Figure 6
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  		Fig 6. Follow-up angiogram after 10 weeks showed complete occlusion of the nidus (arrow) in the mandible.


Figure 7
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  		Fig 7. Axial CT scan of the mandible demonstrated multilocular radiolucency (arrow).


Figure 8
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  		Fig 8. The diffuse capillary blush in the mandible with expansion of the jugular vein was demonstrated on the angiogram of the inferior alveolar artery.


Figure 9
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  		Fig 9. A 3F microcatheter was navigated into the distal end of the inferior alveolar artery, and ethanol injection was given via a transcatheter approach.


Figure 10
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  		Fig 10. The control arteriogram after the procedure documented a significant thrombosis of the lesion.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X