scholarly journals Peripheral Vascular Anomalies – Essentials in Periinterventional Imaging

2019 ◽  
Vol 192 (02) ◽  
pp. 150-162 ◽  
Author(s):  
Maliha Sadick ◽  
Daniel Overhoff ◽  
Bettina Baessler ◽  
Naema von Spangenberg ◽  
Lena Krebs ◽  
...  
Keyword(s):  
Therapeutic Approach ◽  
Vascular Malformations ◽  
Vascular Anomaly ◽  
Flow Dynamics ◽  
Vascular Anomalies ◽  
Vascular Tumors ◽  
Slow Flow ◽  
Peripheral Vascular ◽  
Fast Flow ◽  
Selection Of

Background Peripheral vascular anomalies represent a rare disease with an underlying congenital mesenchymal and angiogenetic disorder. Vascular anomalies are subdivided into vascular tumors and vascular malformations. Both entities include characteristic features and flow dynamics. Symptoms can occur in infancy and adulthood. Vascular anomalies may be accompanied by characteristic clinical findings which facilitate disease classification. The role of periinterventional imaging is to confirm the clinically suspected diagnosis, taking into account the extent and location of the vascular anomaly for the purpose of treatment planning. Method In accordance with the International Society for the Study of Vascular Anomalies (ISSVA), vascular anomalies are mainly categorized as slow-flow and fast-flow lesions. Based on the diagnosis and flow dynamics of the vascular anomaly, the recommended periinterventional imaging is described, ranging from ultrasonography and plain radiography to dedicated ultrafast CT and MRI protocols, percutaneous phlebography and transcatheter angiography. Each vascular anomaly requires dedicated imaging. Differentiation between slow-flow and fast-flow vascular anomalies facilitates selection of the appropriate imaging modality or a combination of diagnostic tools. Results Slow-flow congenital vascular anomalies mainly include venous and lymphatic or combined malformations. Ultrasound and MRI and especially MR-venography are essential for periinterventional imaging. Arteriovenous malformations are fast-flow vascular anomalies. They should be imaged with dedicated MR protocols, especially when extensive. CT with 4D perfusion imaging as well as time-resolved 3D MR-A allow multiplanar perfusion-based assessment of the multiple arterial inflow and venous drainage vessels of arterio-venous malformations. These imaging tools should be subject to intervention planning, as they can reduce procedure time significantly. Fast-flow vascular tumors like hemangiomas should be worked up with ultrasound, including color-coded duplex sonography, MRI and transcatheter angiography in case of a therapeutic approach. In combined malformation syndromes, radiological imaging has to be adapted according to the dominant underlying vessels and their flow dynamics. Conclusion Guide to evaluation of flow dynamics in peripheral vascular anomalies, involving vascular malformations and vascular tumors with the intention to facilitate selection of periinterventional imaging modalities and diagnostic and therapeutic approach to vascular anomalies. Key Points:  Citation Format

scholarly journals Vascular Anomalies (Part II): Interventional Therapy of Peripheral Vascular Malformations

2018 ◽  
Vol 190 (10) ◽  
pp. 927-937 ◽  
Author(s):  
René Müller-Wille ◽  
Moritz Wildgruber ◽  
Maliha Sadick ◽  
Walter Wohlgemuth
Keyword(s):  
Vascular Malformations ◽  
Treatment Strategies ◽  
Interventional Therapy ◽  
Vascular Anomalies ◽  
Vascular Tumors ◽  
Interventional Treatment ◽  
Slow Flow ◽  
Peripheral Vascular ◽  
Percutaneous Sclerotherapy ◽  
Fast Flow

Background The International Society for the Study of Vascular Anomalies (ISSVA) categorizes vascular anomalies into vascular tumors and vascular malformations. Vascular malformations are further divided into slow-flow (venous, lymphatic, and capillary malformation) and fast-flow malformations (arteriovenous malformation and arteriovenous fistula). This interdisciplinary classification has therapeutic implications. Methods The objective of this article is to provide concise information about the current terminology and treatment strategies of peripheral vascular malformations, based on the currently available literature, with a focus on interventional therapy of venous malformations (VM), lymphatic malformations (LM), arteriovenous malformations (AVM) and arteriovenous fistulae (AVF). Results and Conclusion Accurate classification is crucial for appropriate therapy of peripheral vascular malformations. Modern imaging technologies and refined interventional treatment strategies are now central parts in the multidisciplinary management of these patients. Slow-flow and fast-flow vascular malformations can be treated successfully by percutaneous sclerotherapy and endovascular embolotherapy as first-line interventions. Key points:  Citation Format

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

Vascular Anomalies

2019 ◽  
pp. 241-260
Author(s):  
Lara Wine Lee ◽  
Cameron C. Trenor
Keyword(s):  
Functional Impairment ◽  
Vascular Tissue ◽  
Vascular Malformations ◽  
Diagnostic Procedures ◽  
Vascular Anomalies ◽  
Surgical Approaches ◽  
Vascular Tumors ◽  
Vascular Abnormalities ◽  
The Aesthetic ◽  
Excessive Proliferation

The chapter provides a description of the main anomalies characterized by excessive proliferation of the vascular tissue and the major syndromes associated with them. The predominant types of vascular anomalies are vascular tumors and vascular malformations. Vascular tumors are further subdivided in benign, locally aggressive, and malignant, according to the clinical course of the lesions, while vascular abnormalities are classified as simple (capillary, lymphatic, venous, arteriovenous, and arteriovenous fistula) or combined. For each subgroup of vascular anomalies, clinical presentation and diagnostic procedures are discussed, as well as pathogenic mechanisms and potential comorbidities. The management of vascular anomalies may be oriented to treat the aesthetic discomfort as well as the functional impairment and may involve both pharmaceutical and surgical approaches.

DOZ047.40: Bronchopulmonary and vascular anomalies are frequent in children with esophageal atresia

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
S Lejeune ◽  
A L Mee ◽  
L Petyt ◽  
C Mordacq ◽  
R Sfeir ◽  
...  
Keyword(s):  
Ct Scan ◽  
Esophageal Atresia ◽  
Respiratory Symptoms ◽  
Vascular Malformations ◽  
Vascular Anomaly ◽  
Vascular Anomalies ◽  
Ct Scans ◽  
Congenital Cystic Adenomatoid Malformation ◽  
Pediatric Radiologist ◽  
Contrast Enhanced Ct

Abstract Introduction Esophageal atresia (EA) is frequently associated with other malformations although few data are available. Objective Describe tracheobronchial, pulmonary and/or vascular malformations in patients with EA using chest CT scans. Methods Monocentric retrospective study in children with EA, born between 1996 and 2013, who had a CT scan during their follow-up, reviewed by a pediatric radiologist. Results Among 234 children with EA, 48 patients underwent a CT scan available for interpretation, among which 69% were performed to explore persistent respiratory symptoms. Thirty-nine children (81%) were type III EA, 13 (27%) had a VACTERL association. Six patients (13%) had a pulmonary malformation: 4 lobar agenesis, 1 right pulmonary aplasia, and 1 congenital cystic adenomatoid malformation. All these patients presented with at least one associated malformation. Combined with the results of laryngotracheal endoscopy (n = 30), 43 patients (90%) had a tracheobronchial anomaly: tracheomalacia for 40 (83%), tracheal stenosis for 12 (25%), right tracheal bronchus for 2 (4%), communicating bronchopulmonary foregut malformation for 1 (2%). Combined with the results of echocardiography (n = 47), 7 patients (15%) had an isolated vascular anomaly, 8 (17%) had an isolated congenital heart disease and 7 (15%) had both. CT scans permitted the diagnosis of 6 pulmonary malformations (13%), 15 tracheobronchial anomalies (31%), and 2 vascular anomalies (4%). Only one patient (2%) in our study presented with an isolated EA. Conclusion Our study confirms the association of tracheobronchial, pulmonary, and vascular anomalies in patients with EA. Contrast-enhanced CT scan is complementary to echocardiography and laryngotracheal endoscopy in the exploration of persistent respiratory symptoms.

scholarly journals Arteriovenous Malformation of the Oral Cavity

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
S. M. Manjunath ◽  
Sujan Shetty ◽  
Ninad J. Moon ◽  
Bhushan Sharma ◽  
Kiran Kumar Metta ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Vascular Anomaly ◽  
Benign Disease ◽  
Vascular Tumors ◽  
Management Approach ◽  
Lymphatic Capillary ◽  
Clinical Behavior ◽  
Specific Morphology

Vascular anomalies are a heterogeneous group of congenital blood vessel disorders more typically referred to as birthmarks. Subcategorized into vascular tumors and malformations, each anomaly is characterized by specific morphology, pathophysiology, clinical behavior, and management approach. Hemangiomas are the most common vascular tumors. Lymphatic, capillary, venous, and arteriovenous malformations make up the majority of vascular malformations. Arteriovenous malformation of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent a lethal benign disease. Here we present a case report of a 25-year-old male patient with arteriovenous malformation involving the base of tongue.

scholarly journals Sirolimus for the treatment of vascular anomalies in children

2020 ◽  
Vol 7 (3) ◽  
pp. 22-31
Author(s):  
E. K. Donyush ◽  
Z. A. Kondrashova ◽  
Yu. A. Polyaev ◽  
R. V. Garbuzov
Keyword(s):  
Vascular Malformations ◽  
Venous Malformation ◽  
Antiangiogenic Therapy ◽  
Pneumocystis Pneumonia ◽  
Response To Therapy ◽  
Vascular Anomalies ◽  
Vascular Tumors ◽  
Treatment Regimens ◽  
Transplant Patients ◽  
Results Of Treatment

Vascular anomalies (VA) comprise a heterogeneous group of diseases associated with congenital angiogenesis disorder. There are no currently developed unified protocols and treatment regimens for systemic forms of VA. Numerous advantages show sirolimus, an mTOR inhibitor, as a well tolerated and effective antiproliferative and antiangiogenic therapy in patients with VA. The article presents the results of treatment of 211 patients with VA (6 patients with vascular tumors and 205 patients with vascular malformations) aged 2 months to 17 years (median – 9 years), who received sirolimus therapy for 1–86 months (median – 24 months). Sirolimus was administered at a starting dose of 0.8 mg/m2/day orally in two doses with an interval of 12 hours. The concentration of the blood preparation was maintained in the therapeutic range of 6–15 ng/ml. Since 2015, concomitant therapy with co-trimoxazole for the prevention of Pneumocystis pneumonia has been prescribed only to tracheostomy carriers. When infectious episodes occurred in patients, sirolimus therapy continued without changes in the dose of the drug and did not affect the disease, provided that the therapeutic concentration was maintained. A positive response to therapy was observed in 89.1 % of patients with VA in the form of the size of the vascular mass according to the data of visual examination and instrumental control. All patients showeda clinical response to therapy in the form of relief of painsyndrome, reduction/relief of lymphorrhea, reduction/improvement of hemostasis parameters, and an increase in functional activity and quality. For the entire observation period 2012–2020, when taking sirolimus, not a single severe adverse event occurring in post-transplant patients has been reported that would require discontinuation of the drug. The article presents two clinical cases of sirolimus use in the treatment of patients with kaposiform hemangioendothelioma and extensive venous malformation. Parents are encouraged to use the information in scientific research and publications.

HEAD AND NECK VASCULAR ANOMALIES OUR CLINICAL EXPERIENCE AND LITERATURE REVIEW.

2020 ◽  
Vol VOLUME 8 (ISSUE 1) ◽  
pp. 1-8
Author(s):  
Arulalan Mathialagan
Keyword(s):  
Literature Review ◽  
Head And Neck ◽  
Venous Malformation ◽  
Neck Region ◽  
Vascular Anomaly ◽  
Vascular Anomalies ◽  
Active Management ◽  
Vascular Tumors ◽  
Tertiary Referral Centre ◽  
Prompt Diagnosis

Abstract Background- Head and neck vascular anomalies are a spectrum of lesion ranging from simple asymptomatic malformations to life-threatening airway vascular tumors. Management of these lesion poses a real challenge to even most experienced otolaryngologists.Systematic evaluation and prompt diagnosis and judicial choice of treatment are essential for proper management of these lesions. Material and methods-A retrospective review of the head and neck vascular anomalies over three years, from 2017 to 2019 in a tertiary referral centre. Clinical features, radiology, treatment and follow-up data were studied.We did a literature review to give a comprehensive analysis regarding the diagnosis and treatment of the vascular anomalies of the head and neck region. Results- A total of 25 patients were managed in our department in two years. Of these 25 patients, three patients had infantile haemangioma(12%), six patient had congenital haemangioma(24%), six patients had lymphatic malformation(24%), four patient had an arteriovenous malformation (16%), and six patient had venous malformation (24%). Sixpatients (24%) underwent surgery as treatment, which includes one case of noninvoluting congenital hemangioma (NICH) of the temporal bone, one facial AVM, twolateral neck lymphangiomas, one skull base lymphangioma and a venous neck malformation. All the infantile h a ema n gi oma s we rema n a g e d w i t h o ra l propranolol, three lymphatic malformations underwent sclerotherapy, while the three Arteriovenous malformations (AVM), 􀃶ve congenital haemangiomas and four Venous malformations (VM) were under observation. Conclusion-Managing a vascular anomaly requires a prompt diagnosis based on the ISSVA classi􀃶cation, patients' symptoms and the location of the lesion. Not all vascular anomaly requires active management. Careful case selection and a multidisciplinary team are essential for adequate management of the vascular anomalies. Key Words: Vascular Malformation, Hemangioma, Lymphangioma

COMPRESSION OF THE TRACHEA OR ESOPHAGUS VASCULAR ANOMALIES

PEDIATRICS ◽  
1951 ◽  
Vol 7 (1) ◽  
pp. 69-88
Author(s):  
ROBERT E. GROSS ◽  
EDWARD B.D. NEUHAUSER
Keyword(s):  
Aortic Arch ◽  
Vascular System ◽  
Vascular Malformations ◽  
Pulmonary Ventilation ◽  
Innominate Artery ◽  
Vascular Anomaly ◽  
Vascular Anomalies ◽  
Ligamentum Arteriosum ◽  
Superior Mediastinum ◽  
Clear Idea

Description is given of five different types of anomalies of the great vessels in the superior mediastinum which can produce compression of the esophagus or trachea (or both). These malformations of the vascular system can give rise to difficulties in swallowing and to serious disturbances in pulmonary ventilation. These anomalies include double aortic arch, right aortic arch with a left ligamentum arteriosum, anomalous innominate artery, anomalous left common carotid artery, and an aberrant subclavian artery. The various symptom complexes which can be found with these anomalies are described. Endoscopic visualization of the interior of the esophagus or trachea gives valuable information in some cases. The investigation of these subjects should include fluoroscopic and film studies of the esophagus and trachea by contrast media. Data gathered from such roentgenologic examinations usually give a fairly clear idea of the type of vascular anomaly which is present. It is possible to attack surgically each of these vascular malformations. In general, the esophagus or trachea can be relieved by division of an anomalous vessel or by displacement of an artery in such a manner that it is carried away from the compressed structure. When necessary, these operative procedures can be undertaken in very young babies, even in the presence of a high degree of respiratory obstruction. All the operations have been through a left anterolateral, transpleural approach, under general anesthesia with a closed system. The results of operation in 40 patients are analyzed. It is evident that many vascular anomalies in the thorax which disturb the functions of the esophagus or trachea can now be treated with an excellent chance of relieving the obstructive symptoms.

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