Towards a better treatment of patients with vascular malformations: certified interdisciplinary centers are mandatory

Cucuruz, Beatrix; Koller, Michael; Pfleiderer, Ronja; Geisthoff, Urban; Meyer, L.; Kapp, Friedrich; Lang, Werner; Schmitz‐Rixen, Thomas; Wohlgemuth, Walter A.

doi:10.1016/j.zefq.2021.11.003

Cited by 3 publications

(5 citation statements)

References 21 publications

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“…Obtaining the correct diagnosis of VAs is the first essential step, but in case of orphan diseases, this process is challenging and requires experience in the field due to their rarity and broad spectrum of presentation ( 5 ). For this reason, the education of PCPs on VAs represents an essential prerequisite to reduce the delay between the onset of symptoms and the appropriate diagnosis ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, despite their rarity, patients with vascular malformations are chronically affected and require lifelong care associated with a significant socio-emotional and financial burden ( 19 ). This emphasizes the importance of centralized management of such pathologies in specialized centers and the necessity to improve and strengthen the network between PCPs and specialists ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

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Pediatric vascular anomalies in Austria. Where are we at? A survey among primary care pediatricians

Gasparella,

Senica,

Singer

et al. 2023

Front. Pediatr.

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IntroductionVascular anomalies (VAs) are rare conditions and affected patients often experience a difficult patient journey. Timely diagnosis is only possible if primary caregivers are aware of the anomalies and are connected with dedicated specialists. Aim of our survey was to investigate the knowledge about diagnostic and therapeutic possibilities for children with VAs, and the existing networking among primary pediatric caregivers in Austria.MethodsPrimary care pediatricians in Austria were invited to complete an online questionnaire consisting of 28 questions focusing on pediatric VAs.ResultsOut of 373 invited pediatricians 93 (25%) returned the questionnaires, 86 of which were complete. Most physicians (39/93 42%) answered that they see between 15 and 30 patients with infantile hemangiomas per year. Vascular malformations are rarely treated in the primary care setting; most primary care pediatricians (58/86, 67%) reported that they currently treat fewer than 5 patients with such type of VAs. There was unequivocal agreement among the participants (84/86, 98%) on the need to establish a network of specialists and a registry dedicated to pediatric VAs.ConclusionsThis survey represents the first study shedding light on the awareness of VAs among Austrian pediatricians and can serve as a basis for future investigations and advances in the management of these conditions in Austria and other countries with a similar healthcare setting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pediatric vascular anomalies in Austria. Where are we at? A survey among primary care pediatricians

Gasparella,

Senica,

Singer

et al. 2023

Front. Pediatr.

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“…VMs are diseases with unpredictable clinical evolution and manifestations, which lead to life-threatening conditions in severe cases ( 12 ). The splenic artery is the most common vessel responsible for ISIH, while the gastric or gastroepiploic artery accounts for only 4% ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

“…According to the available literature, optimal diagnostic and therapeutic evidence of ISIH remain controversial ( 12 ). CT angiography (CTA) or digital subtraction angiography (DSA) is considered to be a primary tool for diagnosing ISIH, localizing the bleeding vessel if the hemodynamic and clinical status of patients enables it ( 3 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Spontaneous Intraperitoneal Hemorrhage Due to Vascular Malformations in the Muscularis of the Stomach: A Case Report

Zhou

et al. 2022

Front. Med.

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Idiopathic spontaneous intraperitoneal hemorrhage (ISIH) is a phenomenon caused by spontaneous rupture of intra-abdominal visceral vessels, and vascular malformations (VMs) leading to ISIH are rare in previously reported cases. VMs of the gastric wall, which are commonly located in the mucosa and submucosa, mostly lead to upper gastrointestinal bleeding rather than intraperitoneal hemorrhage. To our knowledge, this is the first report of ISIH caused by VMs in gastric muscularis. In the current case, a 22-year-old male patient presented with sudden abdominal pain for 4 h, accompanied by tachycardia and hypotension. CT revealed a hematoma in the omental bursa and fluids in abdominopelvic cavities. Then intraperitoneal hemorrhage was confirmed after abdominal paracentesis. Furthermore, ultrasonic gastroscopy indicated that vascular malformation in the muscularis of the stomach probably led to intraperitoneal hemorrhage. The patient recovered after conservative treatment based on fluid resuscitation and remained stable for 12 months of follow-up. This case suggests that VMs located in the gastrointestinal tract may lead to ISIH and ultrasonic gastroscopy is helpful in the diagnosis of VMs in the gastrointestinal tract.

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“… 2 The education literature has identified learning gaps for otolaryngology trainees, 3 , 4 and recent studies by international vascular anomaly teams have concluded that there is a need for greater education in medical trainees. 5 , 6 We searched MedEdPORTAL for vascular anomalies, venous malformation, hemangioma , and lymphatic malformation and PubMed for vascular anomalies and education and found no teaching resources regarding congenital vascular anomalies.…”

Section: Introductionmentioning

confidence: 99%

Moving Beyond Hemangioma: Interactive, Multidisciplinary, Case-Based Teaching in Vascular Anomalies for Pediatric Residents

Mojica,

Wolfe

2024

MedEdPORTAL

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Introduction Vascular anomalies are a spectrum of disorders, including vascular tumors and malformations, that often require multispecialty care. The rarity and variety of these lesions make diagnosis, treatment, and management challenging. Despite the recognition of the medical complexity and morbidity associated with vascular anomalies, there is a general lack of education on the subject for pediatric primary care and subspecialty providers. A needs assessment and the lack of an available standardized teaching tool presented an opportunity to create an educational workshop for pediatric trainees using the POGIL (process-oriented guided inquiry learning) framework. Methods We developed a 2-hour workshop consisting of an introductory didactic followed by small- and large-group collaboration and case-based discussion. The resource included customizable content for learning assessment and evaluation. Residents completed pre- and posttest assessments of content and provided written evaluations of the teaching session. Results Thirty-four learners in pediatrics participated in the workshop. Session evaluations were positive, with Likert responses of 4.6-4.8 out of 5 on all items. Pre- and posttest comparisons of four content questions showed no overall statistically significant changes in correct response rates. Learners indicated plans to use the clinical content in their practice and particularly appreciated the interactive teaching forum and the comprehensive overview of vascular anomalies. Discussion Vascular anomalies are complex, potentially morbid, and often lifelong conditions; multispecialty collaboration is key to providing comprehensive care for affected patients. This customizable resource offers a framework for trainees in pediatrics to appropriately recognize, evaluate, and refer patients with vascular anomalies.

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Towards a better treatment of patients with vascular malformations: certified interdisciplinary centers are mandatory

Cited by 3 publications

References 21 publications

Pediatric vascular anomalies in Austria. Where are we at? A survey among primary care pediatricians

Pediatric vascular anomalies in Austria. Where are we at? A survey among primary care pediatricians

Idiopathic Spontaneous Intraperitoneal Hemorrhage Due to Vascular Malformations in the Muscularis of the Stomach: A Case Report

Moving Beyond Hemangioma: Interactive, Multidisciplinary, Case-Based Teaching in Vascular Anomalies for Pediatric Residents

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