Maxillomandibular Vascular Malformations: Report of Four Cases
Maxillomandibular or dental arcade arteriovenous malformations (AVMs) are uncommon lesions with potential for life-threatening bleeding. We report three cases of vascular malformations and a case of pyogenic granuloma and propose a contrast-enhanced computed tomography (CT)-based workup of these les...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2022-04-01
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| Series: | Journal of Clinical Interventional Radiology ISVIR |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728997 |
| _version_ | 1818365963759779840 |
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| author | Krishnan Nagarajan Mohan Amuthabarathi Balasubramanian Krishnan Sekar Sabarish Rajendiran Saravanan |
| author_facet | Krishnan Nagarajan Mohan Amuthabarathi Balasubramanian Krishnan Sekar Sabarish Rajendiran Saravanan |
| author_sort | Krishnan Nagarajan |
| collection | DOAJ |
| description | Maxillomandibular or dental arcade arteriovenous malformations (AVMs) are uncommon lesions with potential for life-threatening bleeding. We report three cases of vascular malformations and a case of pyogenic granuloma and propose a contrast-enhanced computed tomography (CT)-based workup of these lesions for definitive treatment. Four cases of orodental bleeding were diagnosed based on CT angiography (CTA) and treated using endovascular means. Three of them were subsequently operated and confirmed by histopathology. Two were low-flow AVMs, the third one a case of pyogenic granuloma, and one high-flow AVM. The first three lesions were embolized with polyvinyl alcohol particles and subsequently operated and the fourth high-flow one embolized using liquid embolic agent n-butyl cyanoacrylate (Glue). CTA can be used to show separate lesions of arterial vascularity and those of delayed/ venous enhancing lesions. Arterial phase-enhancing lesions are again subdivided in digital subtraction angiography into those of low-to-moderate vascularity and those with high flow, which are treated using particle embolization and liquid glue/onyx (± coil) embolization, respectively. The delayed venous phase enhancing lesions may mimic neoplasms and after tissue biopsy may be managed by sclerotherapy. |
| first_indexed | 2024-12-13T22:28:37Z |
| format | Article |
| id | doaj.art-761abc830d5846fe8047a911d8af9e1b |
| institution | Directory Open Access Journal |
| issn | 2456-4869 |
| language | English |
| last_indexed | 2024-12-13T22:28:37Z |
| publishDate | 2022-04-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Journal of Clinical Interventional Radiology ISVIR |
| spelling | doaj.art-761abc830d5846fe8047a911d8af9e1b2022-12-21T23:29:08ZengThieme Medical Publishers, Inc.Journal of Clinical Interventional Radiology ISVIR2456-48692022-04-01601525710.1055/s-0041-1728997Maxillomandibular Vascular Malformations: Report of Four CasesKrishnan Nagarajan0Mohan Amuthabarathi1Balasubramanian Krishnan2Sekar Sabarish3Rajendiran Saravanan4Department of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, IndiaDepartment of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, IndiaDepartment of Dentistry, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, IndiaDepartment of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, IndiaDepartment of Dentistry, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, IndiaMaxillomandibular or dental arcade arteriovenous malformations (AVMs) are uncommon lesions with potential for life-threatening bleeding. We report three cases of vascular malformations and a case of pyogenic granuloma and propose a contrast-enhanced computed tomography (CT)-based workup of these lesions for definitive treatment. Four cases of orodental bleeding were diagnosed based on CT angiography (CTA) and treated using endovascular means. Three of them were subsequently operated and confirmed by histopathology. Two were low-flow AVMs, the third one a case of pyogenic granuloma, and one high-flow AVM. The first three lesions were embolized with polyvinyl alcohol particles and subsequently operated and the fourth high-flow one embolized using liquid embolic agent n-butyl cyanoacrylate (Glue). CTA can be used to show separate lesions of arterial vascularity and those of delayed/ venous enhancing lesions. Arterial phase-enhancing lesions are again subdivided in digital subtraction angiography into those of low-to-moderate vascularity and those with high flow, which are treated using particle embolization and liquid glue/onyx (± coil) embolization, respectively. The delayed venous phase enhancing lesions may mimic neoplasms and after tissue biopsy may be managed by sclerotherapy.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728997arteriovenous malformationsmaxillomandibular avmsdental arcade avmsct angiographydigital subtraction angiographyembolization |
| spellingShingle | Krishnan Nagarajan Mohan Amuthabarathi Balasubramanian Krishnan Sekar Sabarish Rajendiran Saravanan Maxillomandibular Vascular Malformations: Report of Four Cases Journal of Clinical Interventional Radiology ISVIR arteriovenous malformations maxillomandibular avms dental arcade avms ct angiography digital subtraction angiography embolization |
| title | Maxillomandibular Vascular Malformations: Report of Four Cases |
| title_full | Maxillomandibular Vascular Malformations: Report of Four Cases |
| title_fullStr | Maxillomandibular Vascular Malformations: Report of Four Cases |
| title_full_unstemmed | Maxillomandibular Vascular Malformations: Report of Four Cases |
| title_short | Maxillomandibular Vascular Malformations: Report of Four Cases |
| title_sort | maxillomandibular vascular malformations report of four cases |
| topic | arteriovenous malformations maxillomandibular avms dental arcade avms ct angiography digital subtraction angiography embolization |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728997 |
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