A case of giant arteriovenous malformation in which tooth extraction was performed with transcatheter arterial embolization of the inferior alveolar artery

Arteriovenous malformation (AVM) is a congenital vascular malformation, and AVMs that occur in the stomatognathic region can cause fatal major bleeding during oral surgery.We report a case of a patient with a giant AVM in the oropharynx who underwent embolization followed by tooth extraction and was successfully cured.The patient was a 45-year-old woman who was diagnosed with a right oropharyngeal AVM in 2015 due to bleeding from the right mandibular molar region.Since surgical resection carries a high risk of bleeding and it was hoped that the progression of the lesion would stop with future menopause, a policy of observation was decided.However, in December 2022, she noticed significant movement in her lower right second premolar and first molar, and she visited our hospital again with a diagnosis of severe periodontitis and a request for tooth extraction.Since the tooth extraction site was in close proximity to the AVM and there was a risk of major bleeding, we collaborated with our interventional radiology specialist.After she underwent transcatheter arterial embolization, she underwent extraction of her lower right second premolar and first molar.No serious bleeding problems occurred during the tooth extraction, and the patient healed well.