An interdisciplinary specialist team leads to improved diagnostics and treatment for paediatric patients with vascular anomalies

Mattila, Katariina A.; Kervinen, Kaisa; Kalajoki-Helmiö, Teija; Lappalainen, Kimmo; Vuola, Pia; Lohi, Jouko; Rintala, Risto; Pitkäranta, Anne; Salminen, Päivi

doi:10.1111/apa.13076

Cited by 31 publications

(18 citation statements)

References 16 publications

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“…It maintains a comprehensive electronic hospital record covering all disciplines, excluding records maintained for primary healthcare. The Hospital's paediatric vascular anomaly clinic serves as the primary referral clinic for haemangiomas and vascular birthmarks . The study protocol was approved by the hospital ethics committee.…”

Section: Methodsmentioning

confidence: 99%

“…Misuse of the term haemangioma and of its ICD‐10 code prevented us from executing register‐based patient selection and from sending the questionnaire to randomly selected families . We acquired our hospital district's perinatal statistics on live childbirths within the same catchment area, for 2004‐2007, from the Finnish National Institute for Health and Welfare.…”

Section: Methodsmentioning

confidence: 99%

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Risk factors and morbidity of infantile haemangioma: preterm birth promotes ulceration

et al. 2016

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Risk factors and morbidity of infantile haemangioma: preterm birth promotes ulceration

et al. 2016

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“…Vascular malformations are characterized by defective vessel-maturation with a varying degree of mesenchymal tissue proliferation, including dermal, subcutaneous, fatty and bone tissue [15]. Depending on the vessels involved and flow characteristics, they are divided in venous (VM 70%), lymphatic (LM 15%), arterio-venous (AVM 6%) and capillary (CM 9%) malformations with slow-flow (VM, LM, CM) or fast-flow properties (AVM) [16], [17], [18].…”

Section: Resultsmentioning

confidence: 99%

Interdisciplinary Management of Head and Neck Vascular Anomalies: Clinical Presentation, Diagnostic Findings and Minimalinvasive Therapies

Sadick

Wohlgemuth

Huelse

et al. 2017

European Journal of Radiology Open

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ObjectivesVascular anomalies are included in the 30 000 rare diseases worldwide affecting less than 5/10 000 people. Depending on their morphology and biological properties, they can cause varied disorders with organ involvement. Almost 60% of vascular anomalies have a predilection for the head and neck region in children. Clinical and scientific effort to establish interdisciplinary management concepts for vascular anomalies is increasing worldwide.MethodsEspecially in the head and neck region, clinical impairment and organ dysfunction is associated with cosmetic issues that may represent a physical and psychological issue for the patient. Correct diagnosis, based on clinical presentation and symptoms, is a prerequisite for appropriate therapy, ranging from conservative management to a spectrum of minimally invasive treatment options. We searched PubMed for German and English language published data until December 2016 with focus on clinical studies, review articles and case reports on vascular anomalies with a focus on the head and neck region.ResultsThe last ISSVA update in 2014 has contributed to a better understanding of vascular anomalies, classifying them in vascular tumors and vascular malformations. The predominant representatives of vascular tumors are congenital and infantile hemangiomas. Infantile hemangiomas have the ability of spontaneous regression in more than 80%. Patients with symptomatic growing hemangiomas with ulcerations, bleeding complications and restriction of hearing, swallowing disorder, impairment of vision, or cosmetic dysfigurement require treatment. Therapies include oral propanolol, transcatheter embolization and surgery. Vascular malformations tend to progress with patientś age and are subdivided in slow flow and fast flow lesions. Symptomatic slow flow lesions, e.g. venous and lymphatic malformations, benefit from percutaneous sclerotherapy. Fast flow lesions, as arteriovenous malformations, are rare but undoubtedly therapeutically the most challenging vascular anomaly. Depending on location and size, they may require multiple transcatheter embolization procedures for successful occlusion of the AVM.ConclusionsThis review provides knowledge on the current ISSVA classification of vascular anomalies, their clinical presentation, diagnostic evaluation and minimally invasive therapy options to encourage the establishment of a comprehensive interdisciplinary management for head and neck vascular anomalies.

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“…The underlying malformations are highly variable in angiogenesis and vasculogenesis, can occur in any region of the body, and result in significant physical impairment depending on the degree of severity. Vascular anomalies are considered the most severe and complex amongst vascular diseases [3,4]. In the past the variability of this rare disease often resulted in utilization of imprecise or incorrect clinical terms for diagnosis (e. g. "hemangioma" or "angioma") and utilization of specific, medical speciality related, nomenclatures which would potentially alter the overall understanding of the disease.…”

Section: Introductionmentioning

confidence: 99%

“…The most recent advances in the understanding of vascular anomalies have resulted in increased interest in this disease. The demand and necessity for interdisciplinary centers for vascular anomalies providing optimized, dedicated patient care, is growing [4,10,11].…”

Section: Introductionmentioning

confidence: 99%

Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies – Chances and Challenges for Effective and Efficient Patient Management

Sadick

Dally

Schönberg

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TBackground Radiology is an interdisciplinary field dedicated to the diagnosis and treatment of numerous diseases and is involved in the development of multimodal treatment concepts.Method Interdisciplinary case management, a broad spectrum of diagnostic imaging facilities and dedicated endovascular radiological treatment options are valuable tools that allow radiology to set up an interdisciplinary center for vascular anomalies.Results Image-based diagnosis combined with endovascular treatment options is an essential tool for the treatment of patients with highly complex vascular diseases. These vascular anomalies can affect numerous parts of the body so that a multidisciplinary treatment approach is required for optimal patient care.Conclusion This paper discusses the possibilities and challenges regarding effective and efficient patient management in connection with the formation of an interdisciplinary center for vascular anomalies with strengthening of the clinical role of radiologists. Key points▪ Vascular anomalies, which include vascular tumors and malformations, are complex to diagnose and treat. ▪ There are far more patients with vascular anomalies requiring therapy than interdisciplinary centers for vascular anomalies -there is currently a shortage of dedicated interdisciplinary centers for vascular anomalies in Germany that can provide dedicated care for affected patients. ▪ Radiology includes a broad spectrum of diagnostic and minimally invasive therapeutic tools which allow the formation of an interdisciplinary center for vascular anomalies for effective, efficient and comprehensive patient management. Citation Format

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An interdisciplinary specialist team leads to improved diagnostics and treatment for paediatric patients with vascular anomalies

Cited by 31 publications

References 16 publications

Risk factors and morbidity of infantile haemangioma: preterm birth promotes ulceration

Risk factors and morbidity of infantile haemangioma: preterm birth promotes ulceration

Interdisciplinary Management of Head and Neck Vascular Anomalies: Clinical Presentation, Diagnostic Findings and Minimalinvasive Therapies

Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies – Chances and Challenges for Effective and Efficient Patient Management

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