Endovascular treatment of diffuse mandibular arteriovenous malformation: a case report and literature review

Background: Arteriovenous malformations (AVMs) are rare congenital vascular anomalies involving high-flow shunting between arteries and veins. Intraosseous AVMs of the mandible are particularly uncommon and present substantial diagnostic and therapeutic challenges. Because even minor trauma or dental procedures may trigger severe hemorrhage, early recognition and appropriate management are essential. Case presentation: We describe a 33-year-old woman with a long-standing vascular lesion of the right mandible who developed uncontrolled oral bleeding after tooth extraction. Imaging confirmed a diffuse intraosseous AVM. After multiple unsuccessful treatments elsewhere, she underwent endovascular therapy consisting of super-selective arterial and venous access, coil embolization, and sclerotherapy with absolute ethanol and polidocanol foam. The procedure resulted in complete occlusion of the lesion without complications. Follow-up at 4 days, 6 months, and 1 year showed no recurrence. Conclusion: Mandibular AVMs are complex lesions that carry a significant risk of life-threatening hemorrhage. This case demonstrates that combined endovascular embolization and sclerotherapy can provide effective and durable control. Accurate diagnosis, timely intervention, and continued follow-up are essential to achieving favorable outcomes for this rare condition.