Interventional Treatment Options in Children with Extracranial Vascular Malformations

Schmidt, Volker J.; Olivieri, Martin; Häberle, Beate; Masthoff, Max; Deniz, Sinan; Sporns, Peter; Wohlgemuth, Walter A.; Wildgruber, Moritz

doi:10.1055/a-1728-5686

Cited by 9 publications

(7 citation statements)

References 109 publications

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“…Surgical management involves excision, laser treatment or both (11). Sclerotherapy and embolization as well as drugs like sirolimus are non-surgical options (12)(13)(14). In this series, the most common used options were conventional surgery, laser, and sclerotherapy; however, many patients required multiple treatment sessions and modalities especially patients with VM and LM.…”

Section: Discussionmentioning

confidence: 95%

Vascular Malformations of the Head and Neck in Children

Plettendorff

Werner

Wiegand

2023

In Vivo

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Background/Aim: Vascular malformations are congenital abnormalities that result from disturbances in the embryologic development of the vascular system. A retrospective study at a single institution was performed to determine the localization and treatment patterns for vascular malformations in children. Patients and Methods: A total of 198 pediatric patients were identified. Age at diagnosis and presentation, sex, localization, diagnostics, and therapy were described. Results: The most common diagnosis was lymphatic malformation (LM, 58.6%), followed by venous (VM, 31.8%) and arteriovenous malformation (AVM, 4.5%). The mean age at diagnosis was 2.2 years, while the mean age at presentation at our hospital was 7.2 years. The sex ratio showed a female predominance (1.44:1), which was most evident in children with AVM. The neck, cheek/parotid gland and oral cavity were the most predominant locations. Half of the patients required at least one intervention at our hospital. Especially, CM and LM were managed by watch-and wait, whereas lymphovenous malformation (LVM) and AVM were most often treated. Treatment differed between the various malformation types, the most common used treatment was conventional surgery followed by laser therapy. In case of treatment, the average number of procedures in our hospital was 1.58 for VM, 1.53 for LM, 1.33 for AVM, and 1.0 for LVM. Conclusion: In children with vascular malformations interventional treatment is often necessary, in many cases more than one treatment step is needed. Correct identification of the malformation type is important for optimal treatment and appropriate care of patients with vascular malformations.

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Section: Discussionmentioning

confidence: 95%

Vascular Malformations of the Head and Neck in Children

Plettendorff

Werner

Wiegand

2023

In Vivo

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“…Overall, eight patients were included; five (62.5%) were male, and three (37.5%) were female. Median age was 22 years [total range, 11-56; interquartile range (IQR), [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. One patient had an arteriovenous malformation (classified as Schobinger II and Cho IIIb), four had venous malformations (2x Puig type I, 1x type II and 1x type III), and one each had a mixed venouslymphatic malformation, a glomuvenous malformation and a FAVA (fibroadipose vascular anomaly).…”

Section: Patientsmentioning

confidence: 99%

Ultrasonography-guided radiofrequency ablation of vascular malformations—The moving shot technique

Sporns,

Psychogios,

Blackham

et al. 2024

Front. Med.

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PurposeTo describe a novel ultrasound-guided technique for percutaneous radiofrequency ablation of vascular malformations—the “moving shot technique.”MethodsPreliminary observational cohort study, conducted from June 1, 2019, to January 31, 2021, including all consecutive patients diagnosed with vascular malformations who were treated with ultrasound-guided radiofrequency ablation using the moving shot technique. Only patients who had undergone at least one unsuccessful previous treatment were included (sclerotherapy with ethanol/aethoxysklerol or embolization/surgery).ResultsEight patients with a median age of 22 years (interquartile range, 13–31) were included. Patients had different vascular malformations consisting of 1 arteriovenous malformation, 4 venous malformations, and 1 each a mixed venous-lymphatic malformation, a glomuvenous malformation and a FAVA (fibroadipose vascular anomaly). Malformations were located at the limbs in 5 patients (62.5%), the subcutaneous/intramuscular tissue of the body in 2 patients (25%) and at the chin in 1 patient (12.5%). Clinical symptoms were pain in 8 patients (100%), swelling in 6 patients (75%), and partial immobility in 4 patients (50%). All patients showed an improvement of clinical symptoms after treatment with 7 (87.5%) being completely asymptomatic and 1 (12.5%) showing improvement of immobility and pain. No procedural complications, such as nerve damage or skin burns occurred.ConclusionThe moving shot technique using ultrasonography-guided radiofrequency ablation is a promising technique for the interventional treatment of vascular malformations and should be validated in multicenter-approaches.

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“…Fluoroscopic and/or ultrasound-guided percutaneous sclerotherapy is considered the first-line treatment for VM [ 26 , 27 ]. Initially, contrast agents are commonly used to delineate the full extent and volume of the lesion.…”

Section: Neurointerventional Procedures In the Pediatric Populationmentioning

confidence: 99%

Pediatric Interventional Neuroradiology: Opportunities and Challenges

2023

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Pediatric interventional neuroradiology (PINR) is a relatively new field of diagnostic and therapeutic care in the pediatric population that has seen considerable advances in recent decades. However, it is still lagging behind adult interventional neuroradiology due to a variety of reasons, including the lack of evidence validating pediatric-specific procedures, the relative absence of pediatric-specific equipment, and the challenges in establishing and maintaining PINR competencies in a relatively small number of cases. Despite these challenges, the number and variety of PINR procedures are expanding for a variety of indications, including unique pediatric conditions, and are associated with reduced morbidity and psychological stigma. Continued technological advances, such as improved catheter and microwire designs and novel embolic agents, are also contributing to the growth of the field. This review aims to increase awareness of PINR and provide an overview of the current evidence base for minimally invasive neurological interventions in children. Important considerations, such as sedation, contrast agent use, and radiation protection, will also be discussed, taking into account the distinct characteristics of the pediatric population. The review highlights the usefulness and benefits of PINR and emphasizes the need for ongoing research and development to further advance this field.

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Interventional Treatment Options in Children with Extracranial Vascular Malformations

Cited by 9 publications

References 109 publications

Vascular Malformations of the Head and Neck in Children

Vascular Malformations of the Head and Neck in Children

Ultrasonography-guided radiofrequency ablation of vascular malformations—The moving shot technique

Pediatric Interventional Neuroradiology: Opportunities and Challenges

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