New Approaches to the Treatment of Congenital Vascular Malformations (CVMs)—A Single Centre Experience

Abstract

New approaches to the treatment of CVMs based on a multidisciplinary approach can improve results by fully combined surgical treatment with embolo-sclerotherapy.

Changing Concept on Vascular Malformation: No Longer Enigma

“…18,19) When the treatment is committed, however, the destruction of the lesion 'nidus' itself is warranted to prevent a recurrence. The occlusion/embolization of feeding arteries alone should be condemned since it only stimulates the nidus of the lesion possessing the mesenchymal cell characteristics; the nidus will respond as an embryonic tissue remnant with more aggressive neovascular recruitment and subsequent regrowth exceeding the pretreatment condition becomes inevitable.…”

“…18) Many newly developed tests, mostly non-invasive, can now provide precise diagnosis of each CVM to confirm the clinical impression. 19) The diagnosis per se is now feasible only with these non-to less-invasive tests in the majority of CVMs: Duplex ultrasonography, 20) MRI, 21) Whole body blood pool scintigraphy (WBBPS), 22) Transarterial lung perfusion scintigraphy (TLPS), 23) and Radionuclide lymphoscintigraphy, 24) etc. ( Table 2).…”

“…All the detailed information on each test was fully documented through previous publications. [19][20][21][22][23][24] And the invasive tests (e.g. arteriography, phlebography) in general could be saved till needed as a road map for the treatment except the differential diagnosis with hemangioma or AVM.…”

Degeneración sarcomatosa de malformación arteriovenosa Sarcomatous degeneration arteriovenous malformation

“…ej., oído, vista…). El dolor, la incapacidad funcional y la infección recurrente se incluyen, entre otras, en las indicaciones relativas 6 . El tratamiento de las MAV tiene como objetivo el cierre de las comunicaciones arteriovenosas mediante cirugía convencional o técnicas endovasculares.…”

Title- Review of Treatment Options for Arteriovenous Malformations.

“…Hossein behnia et al 19 says superseletive arterial embolization, followed by trans mandibular curettage is effective and less invasive for small intraosseous AVMs with favorable esthetics. 23,24 says embolo/sclerotherapy should always be followed by surgical excision for complete removal of nidus of AVM.…”