Pre-extraction Embolization of Jaw Arteriovenous Malformations to Reduce Bleeding during Tooth Extraction

This retrospective observational study evaluated the effects of pre-extraction embolization on intraoperative blood loss (IBL) during tooth extraction in patients with jaw arteriovenous malformations (AVMs). Five patients (8 procedures) underwent transarterial embolization (TAE), with or without direct puncture embolization (DPE). Technical success, IBL, clinical success-defined as absence of bleeding requiring transfusion during tooth extraction-and adverse events were assessed. TAE was performed in all procedures. DPE was additionally performed in 5 procedures when dilated venous cavities were present or postoperative bleeding persisted. The median IBL was 5 mL (mean, 408 mL [SD ± 635]), with 2 procedures exceeding 1 L. Technical and clinical success rates were both 87.5%. One patient experienced a severe infectious adverse event requiring hospitalization after discharge. Pre-extraction embolization of jaw AVMs may help reduce bleeding; however, severe hemorrhage can still occur. DPE may assist in rapid hemostasis; however, clinicians need to remain prepared for life-threatening bleeding.