A case of high-flow-type arteriovenous malformation in the mandible and submandibular region

AbstractCongenital arteriovenous malformations are rare causes of congestive cardiac failure in neonates. The most common sites are in the head and liver, but other sites include the thorax, the abdomen and the limbs. The onset of failure is usually not in the immediate neonatal period, but later on in life, albeit that lesions such as the arteriovenous malformation of the vein of Galen, and other arteriovenous malformations in different locations which produce high flow can present early. We describe here the first case, to the best of our knowledge, of prenatal detection of an intrathoracic arteriovenous malformation producing neonatal cardiac failure, which was successfully treated by surgery postnatally.

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High flow arteriovenous malformation with transverse-sigmoid sinus stenosis and congestive venopathy mimicking DAVF

British Journal of Neurosurgery ◽

10.1080/02688697.2021.2024500 ◽

2022 ◽

pp. 1-4

Author(s):

Dinesh D. Menon ◽

Dnyandeep Patil ◽

Bopanna K. M. ◽

Ullas V. Acharya ◽

Paritosh Pandey

Keyword(s):

Arteriovenous Malformation ◽

High Flow ◽

Sigmoid Sinus ◽

Sinus Stenosis

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Primary free fibula reconstruction in life-threatening haemorrhage from high flow arteriovenous malformation of mandible

Indian Journal of Plastic Surgery ◽

10.4103/ijps.ijps_13_18 ◽

2018 ◽

Vol 51 (02) ◽

pp. 222-230

Author(s):

Parvathi Ravula ◽

Srikanth Rangachari ◽

Rammurti Susarla ◽

Laxman Sambari ◽

Srinivas Saraswathi Jammula

Keyword(s):

Arteriovenous Malformation ◽

Curative Resection ◽

High Flow ◽

External Carotid ◽

Primary Reconstruction ◽

Free Fibula Flap ◽

Definitive Therapy ◽

Free Fibula ◽

Life Threatening ◽

Selective Embolisation

ABSTRACT Background: High flow arteriovenous malformation (AVM) of the mandible is rare, but it can present as a life-threatening emergency with severe intraoral bleeding for the first time. The gold standard of treatment for an AVM of the mandible is selective embolisation combined with resection and subsequent reconstructions. With the advent of advanced multidisciplinary techniques aimed at definitive therapy, surgical resection and primary reconstruction can provide an ideal anatomical and functional cure. There are no previous reports on primary resection and reconstruction for life-threatening haemorrhage from high flow AVM of the mandible. Aim: We discuss our approach aimed at definitive therapy in life-threatening intraoral bleeding from large high flow AVM of the mandible. Subjects and Methods: Four patients were managed for life-threatening intraoral bleeding during 2015–2017. Compression was applied over the bleeding point before the airway could be secured by endotracheal tube. Under general anaesthesia, the external carotid artery (ECA) was temporarily occluded using an umbilical tape loop ligature to control the bleeding. Emergency selective embolisation was done, followed by curative resection and primary mandible reconstruction using free fibula flap. Outcome assessed. Results: Temporary occlusion of the ECA successfully controlled the bleeding immediately and facilitated selective embolisation and definitive therapy. All the four cases were successfully reconstructed with a good outcome. There was no recurrence during the follow-up period. Conclusion: In life-threatening intraoral bleeding from large high flow AVM of the mandible, emergency selective embolisation followed by curative resection and primary reconstruction is safe in achieving an ideal cure.

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