Perioperative care of the vascular anomaly patient

Chute, Carol; Stein, Beth E. Shubin; Sylvia, Mary Beth; Spera, Erin

doi:10.1053/j.sempedsurg.2014.07.007

Cited by 8 publications

(8 citation statements)

References 10 publications

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“…12-24 hours post procedure it can be restarted and continued for a further 14 days or until the patient returns to baseline activity levels. 43 If administered for extended periods, heparin levels (anti-factor Xa) should be determined 4 to 6 hours after subcutaneous injection with a prophylactic dosing target of < 0.5 units/mL. 44 Dosing during pregnancy may vary and should be determined by a multidisciplinary team specialising in fetomaternal medicine.…”

Section: Coagulopathy Controlmentioning

confidence: 99%

Venous malformations: Coagulopathy control and treatment methods

et al. 2020

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Venous malformations (VMs) are ectatic channels which arise as a result of vascular dysmorphogenesis, commonly caused by activating mutations in the endothelial tyrosine kinase receptor (TIE2)/phosphatidylinositol 3-kinase (PI3Kinase) pathway. With a prevalence of 1% in the general population, and a diverse clinical presentation depending on site, size and tissue involvement, their treatment requires a personalised and multidisciplinary approach. Larger lesions are complicated by local intravascular coagulopathy (LIC) causing haemorrhagic and/or thrombotic complications which can progress to disseminated intravascular coagulopathy (DIC). Methods We performed a literature review using a PubMed® search and identified 15 articles to include. References of these texts were examined to further expand the literature review. Principle findings: Several treatment options have been explored, including compression, sclerotherapy, laser therapy, cryoablation and surgery in addition to the management of LIC with low-molecular-weight-heparin (LMWH) and other anticoagulants. Targeted molecular therapies acting on the phosphatidylinositol 3-kinase (PI3Kinase)/Protein Kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway are newly emerging. Conclusion Despite a wealth of literature, larger, multi-centric, randomised and prospective trails are required to offer further clarification on the therapeutic management of coagulopathy control and to provide symptomatic benefit to patients with VMs. There should be efforts to provide long term follow up and to use standardised risk stratification tools and quality of life (QOL) questionnaires to aid comparison of agents and treatment protocols.

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Section: Coagulopathy Controlmentioning

confidence: 99%

Venous malformations: Coagulopathy control and treatment methods

et al. 2020

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“…Koagulopathien sind multifaktoriell bedingt. Sie können durch veränderte Flussgeschwindigkeiten und Aktivierung der Gerinnungskaskade sowohl zu vermehrten (unstillbaren) Blutungen, als auch zu Thrombose-und Emboliebildung führen (1,3). Eine ausführliche präoperative Analyse der Gerinnungsparameter und die Bereitstellung von genügend Blutprodukten für einen operativen Eingriff sind daher essenziell.…”

Section: Perioperative Probleme Bei Angeborenen Vaskulären Malformatiunclassified

“…Aber auch postoperativ können Probleme in Form von Wundheilungsstörungen oder Blutungen auftreten (3). Hier spielen Drainagen und Kompressionsverbände eine große Rolle.…”

Section: Perioperative Probleme Bei Angeborenen Vaskulären Malformatiunclassified

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Sekundäre orthopädische Komplikationen bei angeborenen vaskulären Malformationen

Hell¹,

Tsaknakis²,

Koch³

et al. 2017

Phlebologie

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ZusammenfassungAngeborene vaskuläre Malformationen sind häufig mit Problemen des muskuloskeletalen Systems vergesellschaftet. Stimulatives Wachstum führt zu Hypertrophien und Mehrwachstum, wie dies beispielsweise beim Klippel-Trenaunay-Syndrom mit einer zunehmenden Beinlängendifferenz vorkommt. Eine frühzeitige engmaschige klinische und radiologische kinderorthopädische Betreuung ist nötig, um rechtzeitig konservative oder operative Maßnahmen durchzuführen. Gravierende Beinlängendifferenzen im Wachstumsalter können in der Folge zu Skoliosen, aber auch rigiden Kontrakturen führen. Nach entsprechender Beobachtung und Planung sind wachstumshemmende operative Maßnahmen wie beispielsweise eine temporäre Epiphyseodese aufwändigeren verlängernden Verfahren oder Operationen nach Wachstumsabschluss vorzuziehen. Im Vorfeld einer Operation müssen zur Vermeidung von Komplikationen sorgfältige interdisziplinäre Abklärungen und Interventionen erfolgen beispielsweise zur Behandlung von Koagulopathien oder vorbereitenden Embolisationen im Operationsgebiet.

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“…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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Perioperative care of the vascular anomaly patient

Cited by 8 publications

References 10 publications

Venous malformations: Coagulopathy control and treatment methods

Venous malformations: Coagulopathy control and treatment methods

Sekundäre orthopädische Komplikationen bei angeborenen vaskulären Malformationen

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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