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Endovascular embolisation of a complex mandibular AVM: a hybrid transarterial and transvenous approach
  1. Amrin Israrahmed1,
  2. Rohit Agarwal2 and
  3. Gaurav Chauhan3
  1. 1Intervention Radiology, Medanta Hospital, Lucknow, India
  2. 2Radiodiagnosis, Medanta Lucknow, Lucknow, India
  3. 3Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
  1. Correspondence to Dr Rohit Agarwal; rohitkgmu{at}


Mandibular arteriovenous malformations (AVMs) are rare lesions which can present with life-threatening haemorrhage. Endovascular embolisation can be life saving for these patients. We discuss a patient of mandibular AVM, who initially presented with reports of massive oral bleeding. The lesion was only partially embolised via transarterial route, as the nidus could not be penetrated completely. In view of rebleeding within 72 hours from the same site, a second embolisation procedure was done via combined, transarterial and transvenous approaches. Coils and onyx were used as embolising agents. Complete embolisation was achieved via combined approach. No further bleeding episodes were seen at 1-year follow-up. Endovascular embolisation of mandibular AVMs can be technically challenging and, hence, a sound knowledge of the anatomy as well as the possible modification of technique is essential to achieve complete obliteration of the lesion and to maximise the benefit of embolisation and to avoid major radical surgery.

  • Interventional radiology
  • General surgery
  • Plastic and reconstructive surgery

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  • Contributors RA, GC and AI were involved in the endovascular embolisation of the lesion. AI drafted the manuscript and compiled the figures. GC drafted the figure legends. RA has added valuable inputs to the final version of the manuscript and has approved it for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.