Surgical Management of Venous Malformations

2007 ◽  
Vol 22 (6) ◽  
pp. 276-282 ◽  
Author(s):  
D A Loose

Objectives Among vascular malformations, the predominantly venous malformations represent the majority of cases. They form a clinical entity and therefore need clear concepts concerning diagnosis and treatment. This paper presents an overview of contemporary classification as well as tactics and techniques of treatment. According to the Hamburg Classification, predominantly venous malformations are categorized into truncular and extratruncular forms, with truncular forms distinguished as obstructions and dilations, and extratruncular forms as limited or infiltrating. Methods The tactics of treatment represent surgical and non-surgical methods or combined techniques. Surgical approaches utilize different tactics and techniques that are adopted based on the pathologic form and type of the malformation: (I) operation to reduce the haemodynamic activity of the malformation; (II) operation to eliminate the malformation; and (III) reconstructive operation. As for (I), a type of a tactic is the operation to derive the venous flow. In (II), the total or partial removal of the venous malformation is demonstrated subdivided into three different techniques. In this way, the infiltrating as well as the limited forms can be treated. An additional technique is dedicated to the treatment of a marginal vein. Approach (III) involves the treatment of venous aneurysms, where a variety of techniques have been successful. Results Long-term follow-up demonstrates positive results in 91 % of the cases. Conclusion Congenital predominantly venous malformations should be treated according to the principles developed during the past decades in vascular surgery, interventional treatment and multidisciplinary treatment. The days of predominantly conservative treatment should be relegated to the past. Special skills and experiences are necessary to carry out appropriate surgical strategy, and the required operative techniques should be dictated by the location and type of malformation and associated findings.

2021 ◽  
Vol 8 (4) ◽  
pp. 477-493
Author(s):  
Isabel Colmenero ◽  
Nicole Knöpfel

Our knowledge in vascular anomalies has grown tremendously in the past decade with the identification of key molecular pathways and genetic mutations that drive the development of vascular tumors and vascular malformations. This has led us to better understand the pathogenesis of vascular lesions, refine their diagnosis and update their classification while also exploring the opportunity for a targeted molecular treatment. This paper aims to provide an overview of venous malformations (VM) in childhood. Specific entities include common VMs, cutaneo-mucosal VM, blue rubber bleb nevus syndrome or Bean syndrome, glomuvenous malformation, cerebral cavernous malformation, familial intraosseous vascular malformation and verrucous venous malformation. The clinicopathological features and the molecular basis of each entity are reviewed.


2021 ◽  
pp. 80-82
Author(s):  
B.V Subhash ◽  
Alba Dinesh ◽  
Seema Patil ◽  
Asha R Iyengar ◽  
Revan Kumar Joshi ◽  
...  

The vascular anomalies consist of vascular tumours and vascular malformations. One among these are the venous malformations which constitute about 40% of all vascular malformations. Usually, the venous malformations present as localized lesions in the form of swellings/nodules with phleboliths, are diagnosed by ultrasonography, CT and MRI. Summary: This is a report of a rare longstanding case of wide spread venous malformations of oral cavity and facial area with phleboliths.


2020 ◽  
Vol 03 (01) ◽  
pp. e10-e15
Author(s):  
Yuki Sato ◽  
Takao Hamamoto ◽  
Takashi Ishino ◽  
Tsutomu Ueda ◽  
Masay Takumida ◽  
...  

AbstractVenous malformations commonly occur in the head and neck regions, in the mucous membrane of the nasal and oral cavities. Venous malformations are found in the extremities in 40% of cases, in the trunk in 20% of cases, and in the cervicofacial area in 40% of cases. However, they are rarely encountered in the parapharyngeal space. We report our experience of surgical treatment of a patient with this rare tumor. The patient was a 21-year-old man who presented with a left mandibular swelling and was admitted to a nearby hospital. He was referred to our hospital for examination and treatment. Contrast-enhanced computed tomography (CT) revealed a bulky tumor with some calcification in the parapharyngeal space; on contrast-enhanced CT, the tumor showed some enhanced effects in the arterial and venous phases. Additional enhancement magnetic resonance imaging (MRI) showed the lesion as low signal intensity on T1-weighted images and as high signal intensity on T2-weighted images, and contrast-enhanced MRI showed some enhanced effects of the lesion. Based on these findings, we suspected venous malformation and performed surgical excision. Histopathology confirmed the venous malformation, and the lesion was diagnosed as a cavernous angioma. Vascular malformations in the head and neck regions should be precisely diagnosed so that appropriate multimodality treatment can be undertaken.


1995 ◽  
Vol 83 (1) ◽  
pp. 141-144 ◽  
Author(s):  
Bernhard Meyer ◽  
Armin P. Stangl ◽  
Johannes Schramm

✓ In this article the authors report the case of a mixed cerebrovascular malformation in which a true arteriovenous malformation (AVM), harboring a nidus, is associated with a venous malformation that serves as the draining vein for the nidus. Despite the authors' preoperative rationale for exclusive extirpation of the AVM, an inadvertent injury and the obliteration of the venous malformation generated delayed postoperative neurological deterioration, which could clearly be attributed to venous hemorrhagic infarction. Because this is only the second instance of this type of mixed vascular malformation of the brain reported, which also underscores the concept of nonsurgical treatment of venous malformations, the authors discuss the diverse literature regarding mixed vascular malformations and the treatment of venous malformations.


2003 ◽  
Vol 9 (2) ◽  
pp. 169-176 ◽  
Author(s):  
J.I. Chung ◽  
H. Alvarez ◽  
P. Lasjaunias

We report a sporadic case of probable BRBN (blue rubber bleb nevus syndrome) with multiple CNS (central nervous system) involvement. These features consisted of multiple VMs (venous malformations) and DVAs (developmental venous anomalies) in supratentorial brain, cerebellum, and diencephalon. Since its first description by Bean, there have been many cases of BRBN manifesting with gastrointestinal bleeding with or without associated hemorrhage. Cases with CNS involvement were rarely reported and many of the descriptions were confusing with different terminologies used to describe them such as capillary venous malformation, hemangiomas, and vascular malformations. The lesions illustrated are venous malformations similar to our case. The association of DVA was recognized in some cases; they are likely to be underestimated when revisiting the published case illustrations. Although our case is sporadic, the link with HHT1 is unlikely despite the involvement of the same chromosome (Ch 9).


VASA ◽  
2010 ◽  
Vol 39 (1) ◽  
pp. 54-58
Author(s):  
Mouton ◽  
Klippert ◽  
Wenning ◽  
Naef ◽  
Wagner

Background: To determine the incidence and significance of vascular malformations in a varicose vein surgery patient cohort in a prospective cohort study. Patients and methods: During a ten year time span we prospectively searched for patients with vascular malformations within a varicose vein surgery cohort. All patients underwent colour duplex sonography and surgery for symptomatic chronic venous disease or chronic venous insufficiency corresponding to clinical classes C2 to C6 according to CEAP. Results: Five out of 1488 patients had truncular vascular malformations. One patient had an arterio-venous malformation in the groin. Venous malformations were found in three marginal veins and one bone perforating vein. Two of these five patients had a mitral valve prolapse syndrome, one a persistent foramen ovale, one had a bone cyst in a finger and one ectromelia of the hands and feet, respectively. No complications occurred following surgical treatment of these five malformations. Conclusions: Truncular arterio-venous and venous malformations in a varicose vein surgery patient cohort are rare. In our cohort the hemodynamic impact of the vascular malformations was low, the surgical treatment combined with varicose vein surgery resulted in technical and clinical success.


2020 ◽  
pp. 026835552094621
Author(s):  
Yu-Yu Han ◽  
Li-Ming Sun ◽  
Si-Ming Yuan

Venous malformation is one of the slow-flow vascular malformations. Dysfunction of coagulation often occurs in most venous malformations, especially the diffuse and multifocal lesions, referred to as localized intravascular coagulopathy. It is characterized by the elevation of D-dimers and fibrin degradation products, low levels of fibrinogen, FV, FVIII, FXIII, and antithrombin III, and sometimes minor-to-moderate thrombocytopenia. Here we reviewed the clinical manifestations, pathogenesis, diagnosis, and treatment of localized intravascular coagulopathy in venous malformations.


2021 ◽  
pp. 396-401
Author(s):  
Karny Shouchane-Blum ◽  
Iftach Yassur ◽  
Amir Sternfeld ◽  
Miriam Regev ◽  
Orly Gal-Or ◽  
...  

Lymphatic-venous malformations (LVMs) are development defects that result in abnormal connections between the lymphatic and venous systems. The authors describe a 7-weeks-old female infant who presented with a right orbital LVM extending to the ipsilateral cheek and subconjunctiva of the right eye, intracranial developmental venous anomalies in the right cerebellum, and a significant right eye intraocular retinal vascular malformation. Since orbital LVM is usually diagnosed in infancy or childhood, pediatric ophthalmologists should actively look for intraocular vascular malformations as such findings can poorly affect a patient’s vision.


VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 477-483
Author(s):  
Robert Karl Clemens ◽  
Frederic Baumann ◽  
Marc Husmann ◽  
Thomas Oleg Meier ◽  
Christoph Thalhammer ◽  
...  

Abstract. Background: Congenital venous malformations are frequently treated with sclerotherapy. Primary treatment goal is to control the often size-related symptoms. Functional impairment and aesthetical aspects as well as satisfaction have rarely been evaluated. Patients and methods: Medical records of patients who underwent sclerotherapy of spongiform venous malformations were reviewed and included in this retrospective study. The outcome of sclerotherapy as self-reported by patients was assessed in a 21 item questionnaire. Results: Questionnaires were sent to 166 patients with a total of 327 procedures. Seventy-seven patients (48 %) with a total of 159 procedures (50 %) responded to the survey. Fifty-seven percent of patients were male. The age ranged from 1 to 38.1 years with a median age of 16.4 years. The lower extremities were the most common treated area. Limitations caused by the venous malformation improved in the majority of patients (e.g. pain improvement 87 %, improvement of swelling 83 %) but also worsening of symptoms occurred in a minority of cases. Seventy-seven per cent would undergo sclerotherapy again. Conclusions: Sclerotherapy for treatment of venous malformations results in significant reduction of symptoms. Multiple treatments are often needed, but patients are willing to undergo them.


2021 ◽  
pp. 1-4
Author(s):  
Serhat Yarar ◽  
Ilker Uyar ◽  
Mehmet Emin Cem Yildirim ◽  
Mehmet Dadacı ◽  
Bilsev Ince

Primary intraosseous vascular malformations (PIVMs) are rare intraosseous lesions, accounting for approximately 0.5–1% of all intraosseous tumours. In this case report, we aimed to present a rare case of intraosseous vascular malformation causing a large lytic area in the parietal bone. A 25-year-old male patient was admitted to the clinic with a mass on the parietal bone. On physical examination, it was observed that the hair density on the mass was decreased, the mass had a soft consistency, and there was no pain on palpation. The patient was operated under local anaesthesia with a provisional diagnosis of a trichilemmal cyst. However, intraoperative diagnosis was a vascular malformation. There was a 3-cm full-thickness defect on the parietal bone caused by the lesion. The mass was excised completely while preserving the integrity of the dura. The resulting defect was reconstructed with bilateral rotation advancement flaps. The calvarial defect was not reconstructed due to equipment inadequacy. No complications were encountered in the postoperative period. Ninety-three PIVM cases have been reported in the skull since 1845. In very few of these cases, the mass is located in the parietal bone. The pathogenesis of PIVMs is not completely understood. The definitive diagnosis is made by histopathological examination. The therapeutic gold standard is surgery. Surgeons should keep in mind that radiological examination before the operation could prevent undesirable complications.


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