scholarly journals Vascular Anomalies of the Oro-Maxillofacial Region

2021 ◽  
pp. 629-658
Author(s):  
Sanjiv Nair ◽  
Sunil S. Shroff
Keyword(s):  
Vascular Malformations ◽  
Treatment Options ◽  
Vascular Anomalies ◽  
Diverse Group ◽  
Imaging Characteristics ◽  
Alternate Therapy ◽  
Systemic Medication ◽  
Anatomical Classification ◽  
Residual Lesions ◽  
Complex Lesions

AbstractVascular anomalies is a diverse group of disorders involving the vasculature (arteries,veins and lymphatics). These lesions in the head and neck can present since birth or later in life causing functional, cosmetic and bleeding problems. They can sometimes co-exist with a wide array of other pathologies and components of various syndromes. The different types, classifications, clinical features, imaging characteristics, treatment options and complications will be discussed in detail, with accordance to guidelines and principles in current literature. The author has designed a widely accepted anatomical classification for surgical management of these complex lesions, which is discussed in depth. Tailoring therapy depending on the anomaly is the key to successful treatment. Hemangiomas tend to proliferate and then involute , hence treated with systemic medication or alternate therapy for residual lesions. Vascular Malformations essentially would require aggressive management with surgery or embolisation and surgery. The concept of ‘corset suturing’ is explained and described, which is thought to be the ideal management for large venous malformations.

Imaging of Pancreatic-Neuroendocrine Tumours: An Outline of Conventional Radiological Techniques

2019 ◽  
Vol 12 (2) ◽  
pp. 135-155 ◽  
Author(s):  
Muhammad Affan Zamir ◽  
Wasim Hakim ◽  
Siraj Yusuf ◽  
Robert Thomas
Keyword(s):  
Neuroendocrine Tumours ◽  
Treatment Options ◽  
Advantages And Disadvantages ◽  
Imaging Characteristics ◽  
Fundamental Understanding ◽  
Pancreatic Neuroendocrine Tumours ◽  
Direct Management ◽  
Important Disease ◽  
Similar Imaging

IIntroduction: Pancreatic Neuroendocrine Tumours (p-NETs) are an important disease entity and comprise of peptide-secreting tumours often with a functional syndrome. : Accounting for a small percentage of all pancreatic tumours, they have a good overall survival rate when diagnosed early, with surgery being curative. The role of nuclear medicine in the diagnosis and treatment of these tumours is evident. However, the vast majority of patients will require extensive imaging in the form of conventional radiological techniques. It is important for clinicians to have a fundamental understanding of the p-NET appearances to aid prompt identification and to help direct management through neoplastic staging. Methods: This article will review the advantages and disadvantages of conventional radiological techniques in the context of p-NETs and highlight features that these tumours exhibit. Conclusion: Pancreatic neuroendocrine tumours are a unique collection of neoplasms that have markedly disparate clinical features but similar imaging characteristics. Most p-NETs are small and welldefined with homogenous enhancement following contrast administration, although larger and less welldifferentiated tumours can demonstrate areas of necrosis and cystic architecture with heterogeneous enhancement characteristics. : Prognosis is generally favourable for these tumours with various treatment options available. However, conventional radiological techniques will remain the foundation for the initial diagnosis and staging of these tumours, and a grasp of these modalities is extremely important for physicians.

scholarly journals Polymer-Drug Conjugates as Nanotheranostic Agents

2021 ◽  
Vol 2 (1) ◽  
pp. 63-81
Author(s):  
Sajana Manandhar ◽  
Erica Sjöholm ◽  
Johan Bobacka ◽  
Jessica M. Rosenholm ◽  
Kuldeep K. Bansal
Keyword(s):  
Drug Delivery ◽  
Drug Release ◽  
Treatment Options ◽  
The Body ◽  
Drug Conjugates ◽  
Imaging Characteristics ◽  
Wide Range ◽  
Systemic Side Effects ◽  
Theranostic Agents ◽  
The Stability

Since the last decade, the polymer-drug conjugate (PDC) approach has emerged as one of the most promising drug-delivery technologies owing to several benefits like circumventing premature drug release, offering controlled and targeted drug delivery, improving the stability, safety, and kinetics of conjugated drugs, and so forth. In recent years, PDC technology has advanced with the objective to further enhance the treatment outcomes by integrating nanotechnology and multifunctional characteristics into these systems. One such development is the ability of PDCs to act as theranostic agents, permitting simultaneous diagnosis and treatment options. Theranostic nanocarriers offer the opportunity to track the distribution of PDCs within the body and help to localize the diseased site. This characteristic is of particular interest, especially among those therapeutic approaches where external stimuli are supposed to be applied for abrupt drug release at the target site for localized delivery to avoid systemic side effects (e.g., Visudyne®). Thus, with the help of this review article, we are presenting the most recent updates in the domain of PDCs as nanotheranostic agents. Different methodologies utilized to design PDCs along with imaging characteristics and their applicability in a wide range of diseases, have been summarized in this article.

Treatment options and long-term outcomes in pediatric spinal cord vascular malformations: a case report and review of the literature

2020 ◽  
Vol 36 (12) ◽  
pp. 3147-3152
Author(s):  
Helen J. Zhang ◽  
Nicole Silva ◽  
Elena Solli ◽  
Amanda C. Ayala ◽  
Luke Tomycz ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Vascular Malformations ◽  
Treatment Options ◽  
Review Of The Literature ◽  
Long Term Outcomes

scholarly journals Predictors of mortality in patients with hereditary hemorrhagic telangiectasia

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
K. P. Thompson ◽  
◽  
J. Nelson ◽  
H. Kim ◽  
L. Pawlikowska ◽  
...  
Keyword(s):  
Hereditary Hemorrhagic Telangiectasia ◽  
Cox Regression ◽  
Clinical Symptoms ◽  
Vascular Malformations ◽  
Smoking Status ◽  
Treatment Options ◽  
Gi Bleeding ◽  
Cox Regression Analysis ◽  
Predictors Of Mortality

Abstract Background Retrospective questionnaire and healthcare administrative data suggest reduced life expectancy in untreated hereditary hemorrhagic telangiectasia (HHT). Prospective data suggests similar mortality, to the general population, in Denmark’s centre-treated HHT patients. However, clinical phenotypes vary widely in HHT, likely affecting mortality. We aimed to measure predictors of mortality among centre-treated HHT patients. HHT patients were recruited at 14 HHT centres of the Brain Vascular Malformation Consortium (BVMC) since 2010 and followed annually. Vital status, organ vascular malformations (VMs) and clinical symptoms data were collected at baseline and during follow-up (N = 1286). We tested whether organ VMs, HHT symptoms and HHT genes were associated with increased mortality using Cox regression analysis, adjusting for patient age, sex, and smoking status. Results 59 deaths occurred over average follow-up time of 3.4 years (max 8.6 years). A history of anemia was associated with increased mortality (HR = 2.93, 95% CI 1.37–6.26, p = 0.006), as were gastro-intestinal (GI) bleeding (HR = 2.63, 95% CI 1.46–4.74, p = 0.001), and symptomatic liver VMs (HR = 2.10, 95% CI 1.15–3.84, p = 0.015). Brain VMs and pulmonary arteriovenous malformations (AVMs) were not associated with mortality (p > 0.05). Patients with SMAD4 mutation had significantly higher mortality (HR = 18.36, 95% CI 5.60–60.20, p < 0.001) compared to patients with ACVRL1 or ENG mutation, but this estimate is imprecise given the rarity of SMAD4 patients (n = 33, 4 deaths). Conclusions Chronic GI bleeding, anemia and symptomatic liver VMs are associated with increased mortality in HHT patients, independent of age, and in keeping with the limited treatment options for these aspects of HHT. Conversely, mortality does not appear to be associated with pulmonary AVMs or brain VMs, for which patients are routinely screened and treated preventatively at HHT Centres. This demonstrates the need for development of new therapies to treat chronic anemia, GI bleeding, and symptomatic liver VMs in order to reduce mortality among HHT patients.

Spinal artery aneurysms: clinical presentation, radiological findings and outcome

2018 ◽  
Vol 10 (7) ◽  
pp. 644-648 ◽  
Author(s):  
Leonardo Renieri ◽  
Eytan Raz ◽  
Giuseppe Lanzino ◽  
Timo Krings ◽  
Maksim Shapiro ◽  
...  
Keyword(s):  
Back Pain ◽  
Retrospective Review ◽  
Clinical Presentation ◽  
Treated Patient ◽  
Demographic Data ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Imaging Characteristics ◽  
Arterial Aneurysms

Background and purposeSpinal arterial aneurysms are a rare cause of spinal subarachnoid hemorrhage (SAH). We performed a retrospective review of spinal arterial aneurysms not associated with spinal arteriovenus shunts from three institutions in order to better understand the clinical and imaging characteristics of these lesions.Materials and methodsWe performed a retrospective review of spinal arterial aneurysms managed at three North American institutions. For each patient, the following information was collected: demographic data, clinical presentation, comorbidities, imaging findings, and neurological status at the last follow-up. Treatment strategies and outcomes were reported.Results11 patients were included; 7 were women and median age was 60 years. The most common presentation was sudden back pain (81.8%). We found 3 aneurysms on the radiculomedullary artery and 8 along the radiculopial arteries. Of the 3 aneurysms on the radiculomedullary artery, 1 was treated conservatively, 1 was treated with coiling of the aneurysm and sacrifice of the radiculomedullary artery, and 1 was treated with surgical trapping. The 8 aneurysms on the radiculopial artery were treated endovascularly in 4 cases, surgically in 1 case, and conservatively in 3 cases. One surgically treated patient had a spinal subdural hematoma. There were no other complications. Mean clinical follow-up time was 20 months, and 87.5% of patients were functionally independent.ConclusionsSpinal arterial aneurysms are lesions which commonly present with sudden back pain and spinal SAH. Conservative, surgical, and endovascular treatment options are safe and effective. Long term outcomes in these patients are generally good.

scholarly journals Cavernous Hemangioma of the Tongue

2015 ◽  
Vol 6 (3) ◽  
pp. 109-111 ◽  
Author(s):  
Jatin P Shah ◽  
Ivana Petrovic ◽  
Ben Roman
Keyword(s):  
Cavernous Hemangioma ◽  
Soft Tissues ◽  
Vascular Malformations ◽  
Surgical Excision ◽  
Vascular Anomalies ◽  
Preoperative Imaging ◽  
Vascular Tumors ◽  
Adult Onset ◽  
Complete Excision ◽  
Intramuscular Hemangioma

ABSTRACT Background Vascular anomalies are divided into vascular tumors, hemangiomas being the most common, and vascular malformations. Most vascular anomalies are noticed at birth or occur during infancy, and generally involve skin or subcutaneous soft tissues. Adult onset hemangiomas are rare, and intramuscular location is extremely rare. Surgical excision is recommended for hemangiomas in adults, if they are symptomatic, or manifest growth. Materials and methods We report a rare case of a 51-year-old woman, with an intramuscular hemangioma of the tongue, presenting as a submental mass. Preoperative imaging for assessment of tumor extent was followed by a successful surgical excision. Results Postoperative course was uneventful with primary healing of the wound, and with no functional deficit of tongue function. Conclusion Although a variety of treatment approaches are reported for childhood hemangiomas, surgical excision is the preferred treatment for adult onset symptomatic hemangiomas. Preoperative work up should include imaging preferably with contrast enhanced magnetic resonance imaging (MRI). Embolization may be considered for larger lesions. Intraoperative hypotension should be avoided to ensure identification of the entire lesion to ensure complete excision. How to cite this article Petrovic I, Roman B, Shah JP. Cavernous Hemangioma of the Tongue. Int J Head Neck Surg 2015;6(3):109-111.

scholarly journals Vascular Anomalies (Part I): Classification and Diagnostics of Vascular Anomalies

2018 ◽  
Vol 190 (09) ◽  
pp. 825-835 ◽  
Author(s):  
Maliha Sadick ◽  
René Müller-Wille ◽  
Moritz Wildgruber ◽  
Walter Wohlgemuth
Keyword(s):  
Classification System ◽  
Vascular Malformations ◽  
Color Doppler ◽  
Vascular Anomalies ◽  
Endothelial Cell Proliferation ◽  
Vascular Tumors ◽  
Interdisciplinary Management ◽  
Venous Malformations ◽  
Medical Evaluation ◽  
Malformation Syndromes

Background Vascular anomalies are a diagnostic and therapeutic challenge. They require dedicated interdisciplinary management. Optimal patient care relies on integral medical evaluation and a classification system established by experts in the field, to provide a better understanding of these complex vascular entities. Method A dedicated classification system according to the International Society for the Study of Vascular Anomalies (ISSVA) and the German Interdisciplinary Society of Vascular Anomalies (DiGGefA) is presented. The vast spectrum of diagnostic modalities, ranging from ultrasound with color Doppler, conventional X-ray, CT with 4 D imaging and MRI as well as catheter angiography for appropriate assessment is discussed. Results Congenital vascular anomalies are comprised of vascular tumors, based on endothelial cell proliferation and vascular malformations with underlying mesenchymal and angiogenetic disorder. Vascular tumors tend to regress with patient’s age, vascular malformations increase in size and are subdivided into capillary, venous, lymphatic, arterio-venous and combined malformations, depending on their dominant vasculature. According to their appearance, venous malformations are the most common representative of vascular anomalies (70 %), followed by lymphatic malformations (12 %), arterio-venous malformations (8 %), combined malformation syndromes (6 %) and capillary malformations (4 %). Conclusion The aim is to provide an overview of the current classification system and diagnostic characterization of vascular anomalies in order to facilitate interdisciplinary management of vascular anomalies. Key Points  Citation Format

Management of Hepatic Hemangioendotheliomas of Infancy by Transarterial Embolization: A Report of Two Cases

PEDIATRICS ◽  
1984 ◽  
Vol 73 (4) ◽  
pp. 546-549
Author(s):  
D. H. JOHNSON ◽  
A. M. VINSON ◽  
F. H. WIRTH ◽  
H. J. PRESBERG ◽  
G. HARKINS ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Vascular Malformations ◽  
Transarterial Embolization ◽  
Treatment Options ◽  
Surgical Excision ◽  
Vascular Tumors ◽  
Artery Ligation ◽  
Abdominal Ultrasonography ◽  
Abdominal Masses

Hepatic hemangioendotheliomas are uncommon vascular tumors which present as abdominal masses, unexplained jaundice, bleeding disorders, or congestive heart failure.1-3 Death often results from congestive heart failure despite appropriate treatment with digoxin and diuretics.4 Verification of hepatic vascular malformations rests on selective angiography,5 hepatic scintigraphy,6 computed tomography,7 and abdominal ultrasonography.8 Successful treatment of heart failure depends on elimination of the malformation's left-to-right shunt and its adverse cardiac effects. Present theapeutic recommendations for symptomatic patients remain divided. Treatment options include surgical excision of localized lesions,9 hepatic artery ligation,10 radiation,11 and glucocorticoid therapy12,13, often combinations of these programs are used.

Is There an Association Between Hemangioma and Syndromes With Dysmorphic Features?

PEDIATRICS ◽  
1991 ◽  
Vol 88 (6) ◽  
pp. 1257-1267
Author(s):  
A. Jay Burns ◽  
Lawrence C. Kaplan ◽  
John B. Mulliken
Keyword(s):  
Aortic Arch ◽  
Vascular Malformations ◽  
Vascular Anomalies ◽  
Vascular Lesions ◽  
Dysmorphic Features ◽  
Vascular Birthmarks ◽  
Neonatal Tumor ◽  
Nevus Flammeus ◽  
Genitourinary Defects

Most vascular birthmarks can be categorized, based on clinical and cellular criteria, as either (1) a hemangioma, or (2) a malformation, or (3) a macular stain. Macular stains are commonly seen in newborns, and they consist of faint vascular stains of the glabella, eyelids, and nuchal region called "nevus flammeus," "stork bite," "salmon patch," etc. Unfortunately, the term "hemangioma" is frequently applied to all three types of cutaneous vascular lesions. Usually, these disparate vascular anomalies are listed in association with various malformative syndromes and are generically labeled "hemangioma." This study attempts to define accurately the specific vascular anomalies seen in children born with syndromes with dysmorphic features. This review of five standard textbooks of genetics showed that the majority of vascular anomalies reported in syndromic newborns are not hemangiomas. Rather, they are macular stains, and the vast majority of these fade with time. Congenital telangiectasias and other vascular malformations (capillary, lymphatic, venous, arterial, and combinations thereof) also occur in association with dysmorphic syndromes. contrast, hemangioma, the most common neonatal tumor, is seen only incidentally with rare dysmorphic conditions. Specifically, hemangioma was found to occur only in association with midline (sternal, abdominal) clefting, right-sided aortic arch coarctation, and with a constellation of sacral and genitourinary defects.

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