Contact us
via e-mail »
Athens
210 3646955
heraklion crete
2810 282123
giatroi Vascular Diseases

Vascular malformations

Please note the information provided is intended to support patients and is not a substitute for medical advice and treatment. We strongly recommend consultation with your doctor or health care professional, before using any information obtained from articles of this website.

What is a vascular malformation?

The term vascular malformation is a general term and includes any malformation (i.e. congenital anomaly) involving vessels. A vascular malformation may be located anywhere in the body.

There are venous malformations (only veins), lymphatic malformations (only lymph vessels), venolymphatic malformations (veins and lymph vessels) and arteriovenous malformations (arteries directly connected to veins without capillaries in between).

Go to top

When do vascular malformations appear?

Although all vascular malformations are present at birth, they become apparent at different ages. We know that they occur during embryonic development, but we do not know what causes them. There is currently scientific work done with regard to the genetics of vascular malformations. Hereditary haemorrhagic telangiectasia is inherited as an autosomal dominant trait.

Go to top

What are the symptoms of vascular malformations?

Venous malformations – They may cause pain locally. Venous and lymphatic malformations may cause a lump under the skin with a birthmark on the overlying skin. Venous and lymphatic malformations may be associated with Klippel-Trenaunay syndrome.

Arteriovenous malformations – They may cause pain. If there have a very high blood flow, they may be stressful on the heart causing cardiac failure. Depending on their location they may cause bleeding (in organs like the bowels, the uterus and the bladder). They may also cause ischaemia, i.e. significant reduction of blood flow to more distal tissues; for example, an arteriovenous malformation at the level of the ankle may cause ischaemic rest pain in the forefoot because of shunt of blood from arteries to veins. When they occur in the head and neck, they may cause severe tinnitus.

Go to top

Are haemangiomas related to vascular malformations?

A haemangioma is not a vascular malformation, but a benign tumour which may be present at birth.

Haemangiomata may also present as birthmarks, however, they grow rapidly early in life and at a second stage they show spantaneous involution (although this process may last for several years), as opposed to the vascular malformations which grow proportionally to the child’s growth. Vascular malformations do not involute spontaneously.

Go to top

How are vascular malformations studied?

Physical examination is often helpful to diagnose these lesions. To study deeper tissues or to demonstrate arteriovenous shunts, magnetic resonance imaging (MRI) or digital subtractive angiography may be used.

Go to top

What is the treatment of vascular malformations and how effective is it?

Management depends upon the type of vascular malformation.

In certain cases, when the lesion is relatively localised, surgical excision may be radical and, therefore, very effective. However, it is generally difficult to completely remove a rather extensive vascular malformation, which will return if not removed completely.

Some vascular malformations are complex lesions (extensive, affecting several tissues or vital organs etc) and may require treatment by a multidisciplinary group of physicians apart from the vascular surgeon, consisting of interventional radiologist, plastic surgeon, orthopaedic surgeon, general surgeon, ENT or thoracic surgeon.

If a feeding artery of a lesion is recognised (the case with an arteriovenous malformation or a haemangioma), embolisation can be performed with suitable material (like absolute alcohol or “glue”, i.e. N-butyl-2-cyanoacrylate), which is injected via an angiography catheter until the lesion is fully devascularised and no longer has blood flowing through it. In general, embolisation is an effective method, although it may require a series of treatments. Some venous and lymphatic malformations may be treated with direct puncture and embolisation (usually with absolute alcohol or 3% sodium tetradecyl sulphate, STD).

Go to top

Does a vascular malformation require long-term surveillance?

All vascular malformations require long-term surveillance – even following treatment – most importantly at puberty, pregnancy, menopause or after injury, because new symptoms may appear speeding up the need for interventional treatment.

Go to top

EXTERNAL LINK

Last modified 07/07/2015