Surgical Treatment of Vascular Anomalies

Goldenberg, Dov Charles; Zatz, Rafael Ferreira

doi:10.1016/j.det.2022.06.006

Cited by 6 publications

(4 citation statements)

References 44 publications

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“…Low-flow malformations are often faring far better than high-flow lesions. 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).…”

Section: Discussionmentioning

confidence: 99%

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: 99%

Vascular Malformations of the Head and Neck in Children

Plettendorff

Werner

Wiegand

2023

In Vivo

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“…104 Subsequently, complete surgical resection of the nidus is critical, as partial resection has a higher recurrence rate. 104 For more conservative measures, long-term sirolimus treatment appears promising. 105 However, trametinib, an MEK inhibitor drug, is a promising candidate for treating arteriovenous malformations.…”

Section: Arteriovenous Malformationsmentioning

confidence: 99%

“…10 Preoperative embolization or sclerotherapy with bleomycin, doxycycline, ethanol, or sodium tetradecyl sulfate is the most common procedure for treating arteriovenous malformations to occlude the nidus and prevent hemorrhage. 104 Subsequently, complete surgical resection of the nidus is critical, as partial resection has a higher recurrence rate. 104 For more conservative measures, long-term sirolimus treatment appears promising.…”

Section: Arteriovenous Malformationsmentioning

confidence: 99%

Congenital Vascular and Lymphatic Diseases

Jung,

Trivedi

2024

Circulation Research

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Over the past several centuries, the integration of contemporary medical techniques and innovative technologies, like genetic sequencing, have played a pivotal role in enhancing our comprehension of congenital vascular and lymphatic disorders. Nonetheless, the uncommon and complex characteristics of these disorders, especially considering their formation during the intrauterine stage, present significant obstacles in diagnosis and treatment. Here, we review the intricacies of these congenital abnormalities, offering an in-depth examination of key diagnostic approaches, genetic factors, and therapeutic methods.

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“…1 The treatment of these vascular anomalies has shifted to endovascular management, and embolization and sclerotherapy are currently considered the first line of treatment. 2 However, surgical techniques still play a role in the management of certain conditions, such as microcystic LM, 3 superficial venous thrombosis (SVT), 4 overgrowth with vascular malformation, 5 and FAVA. 6 Resection is usually considered only after endovascular measures have failed to manage either the bulk or symptoms.…”

mentioning

confidence: 99%

Endoscopic Resection for Vascular Anomalies in Children

Wang¹,

Xie²,

Lin³

et al. 2023

Annals of Surgery

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Objective: To report an innovative endoscopic surgery for subcutaneous vascular malformations and intramuscular fibro-adipose vascular anomaly (FAVA) at our center. Background: Historically, open surgical resection has been the treatment of choice. Recent advances in minimally invasive surgery have led to the successful application of endoscopic resection techniques for the surgical management of diseases of soft tissue. Methods: Patients who underwent endoscopic resection of vascular anomalies were included in this retrospective review. Data were extracted from our Vascular Anomalies Center database between September 2019 and October 2022, including sex, age, symptoms, diagnosis, sites of surgery, previous treatment, surgery, and follow-up. Results: There were 13 females and 15 males in the current study, with ages ranging from 1 to 17 years. The diagnoses included microcystic lymphatic malformation (LM) (n = 8), Klippel-Trénaunay syndrome (n = 7), venous malformation (n = 6), FAVA (n = 6), and mixed cystic LM (n = 1). Surgical sites included the lower extremity (n = 24), abdominal wall (n = 2), upper extremity (n = 1), and thoracic wall (n = 1). Five patients had an intramuscular lesion (FAVA). The endoscopic technique used 2 or 3 small ports in a gas inflation manner. Surgery included thrombectomy, radical resection, and debulking of vascular anomalies. Postoperative sclerotherapy with bleomycin was performed through a drainage tube in 6 patients with microcystic LM. Technical success was obtained in 27 patients. The conversion to open surgery was performed in one patient owing to the deep location of the lesion. No wound-related complication was observed. Conclusions: Endoscopic surgery is a minimally invasive, effective, and safe treatment for subcutaneous vascular malformations and intramuscular FAVA. This approach can set a new standard that minimizes wound complications and reduces recovery time in patients undergoing resection for benign soft-tissue lesions.

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Surgical Treatment of Vascular Anomalies

Cited by 6 publications

References 44 publications

Vascular Malformations of the Head and Neck in Children

Vascular Malformations of the Head and Neck in Children

Congenital Vascular and Lymphatic Diseases

Endoscopic Resection for Vascular Anomalies in Children

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