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Dental arcade arteriovenous fistulas: From diagnosis to treatment with emphasis on the role of endovascular or percutaneous treatment: Single centre experience
Institution:1. Dental Research Center, Tehran University of Medical Sciences, Ghods St., Enghelab Ave., P.O. Box: 14155-5583, 14174 Tehran, Iran;2. Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, North Karegar St., Tehran, Iran;3. School of Dentistry, Tehran University of Medical Sciences, North Karegar St., Tehran, Iran;1. Department of Neurologic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905, USA;2. Department of Radiology, Mayo Clinic, Rochester, MN, USA;1. Department of Plastic, Reconstructive and Maxillo-Facial Surgery, and Burn Unity Hospital de São João, Porto Medical School, Alameda Professor Hernâni Monteiro, 4202-451 Porto, Portugal;2. CMUP – Center for Mathematics of University of Porto, Faculdade de Ciências da Universidade do Porto, Rua do Campo Alegre, 687, 4169-007 Porto, Portugal;3. Spinal Neuronal Networks Group, IBMC – Instituto de Biologia Molecular e Celular, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal;1. Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States;2. Oral and Maxillofacial Surgery, University Medical Centre Mainz & Research Fellow Plastic Surgery, Yale School of Medicine, United States;3. Yale Core Center for Musculoskeletal Disorders, United States;4. Section of Plastic & Reconstructive Surgery, Director of Craniofacial Program, Yale School of Medicine, United States;5. Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States;1. Department of Neurology, Charité–Universitätsmedizin, Berlin, Germany;2. Department of Radiology, Charité–Universitätsmedizin, Berlin, Germany;3. Center of Stroke Research, Berlin, Germany.;1. Department of Oral Surgery, Heinrich Heine University, Westdeutsche Kieferklinik, Moorenstr. 5, D-40225 Düsseldorf, Germany;2. Department of Oral Surgery and Radiology, School of Dentistry, Medical University of Graz, Austria;3. Department of Periodontology, Victor Babes University of Medicine, Timisoara, Romania
Abstract:ObjectiveDental arcade arteriovenous fistula (DA-AVF) are rare. The purpose of this study was to understand the angioarchitecture of these lesions, changing strategies of endovascular treatment and to analyse the best therapeutic option which will allow normal skeletal development especially in children.Materials and methodsRetrospective study of all the patients of DA-AVF managed at our centre over the last 16 years. Detailed analysis of the clinical features, the imaging findings, endovascular treatment and angiographic outcomes was done.ResultsTotal of six patients were treated. 5 were in the mandible and one in the maxilla. Transarterial glue embolization was done in 3 patients and direct puncture of the intraosseous venous pouch in 2. Transarterial Onyx was used in 2 patients through dual lumen balloon catheter. Overall cure was achieved in 5 out of 6 patients (83%).ConclusionHigh index of suspicion is required to diagnose it on panoramic radiographs. CT/MR/CTA can lead to early diagnosis. Transarterial Onyx embolization using dual lumen balloon catheter is a promising technique & allows excellent penetration of Onyx into the intraosseous venous pouch.
Keywords:Dental arcade  Arteriovenous fistula  Endovascular treatment  Direct puncture  TransarteriaL Onyx  DA-AVF"}  {"#name":"keyword"  "$":{"id":"kwrd0015"}  "$$":[{"#name":"text"  "_":"Dental arcade arteriovenous fistula  NBCA"}  {"#name":"keyword"  "$":{"id":"kwrd0025"}  "$$":[{"#name":"text"  "_":"N butyl cyanoacrylate  CTA"}  {"#name":"keyword"  "$":{"id":"kwrd0035"}  "$$":[{"#name":"text"  "_":"Computed tomographic angiography
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