Endovascular embolization using a combination of coils and absolute ethanol is a clinically viable and effective strategy for the management of parotid congenital arteriovenous fistulas, achieving 100% complete symptom resolution at 1-year follow-up.
Pulsation was the predominant clinical manifestation of parotid congenital arteriovenous fistulas, present in nearly all patients.
Combined endovascular embolization with coils and absolute ethanol achieved an 86.7% complete response rate at 3-month and 6-month follow-ups after initial treatment.
The final complete symptom resolution rate reached 100% at the 1-year follow-up after repeat sessions in selected cases.
Transient localized swelling occurred universally in all patients following endovascular embolization, while more serious complications were rare.
The study population included both pediatric and adult patients, with parotid congenital arteriovenous fistulas presenting across a wide age range.
This research studied a minimally invasive procedure for treating a rare condition called congenital arteriovenous fistulas (cAVFs) in the parotid gland region — an area near the jaw and ear. These are abnormal connections between arteries and veins that people are born with, and they can cause symptoms like pulsating sensations, a humming or vibrating feeling (thrill), warm skin, ringing in the ears, and occasionally bleeding. The study followed 15 patients, including both children and adults, who were treated using a two-step approach: first, tiny metal coils were inserted into the abnormal blood vessel to slow blood flow, and then a small amount of pure alcohol (absolute ethanol) was injected to close off the remaining abnormal connection. The results showed that the treatment was highly effective. After the initial procedure, about 87% of patients had complete resolution of their symptoms within 3 to 6 months. By the one-year mark, all 15 patients (100%) had achieved complete symptom resolution, with a small number requiring an additional treatment session. The most common side effect was temporary swelling at the site, which happened in every patient but went away on its own. Two more serious but still uncommon complications — temporary facial nerve weakness and a coil working its way toward the ear canal — each occurred in only one patient and both resolved with appropriate care. This research suggests that combining coils and pure alcohol for endovascular (inside the blood vessel) treatment is a safe and effective approach for managing these complex vascular abnormalities in the parotid region, offering a viable alternative to open surgery. The technique appeared effective in both children and adults, and the absence of major systemic complications is encouraging, though the small sample size of 15 patients means larger studies would be needed to confirm these findings more broadly.
Wang Z, Shen Y, Wang Z, Han Y, Zheng L, Wen M, et al.. (2026). Endovascular treatment of congenital arteriovenous fistulas in the parotid region using coils and absolute ethanol.. Frontiers in neurology. https://doi.org/10.3389/fneur.2026.1787924