Surgical Treatment of Peripheral Vascular Malformations: A Systematic Review and Meta-Analysis

Abstract

eripheral vascular malformations are congenital anomalies of the vascular or lymphatic system, often visible as a mass different in color and texture than normal skin. Present at birth, the abnormally dilated vessels grow proportionally with the body; they are noninvasive, but may expand due to trauma or hormonal changes. The lesions are classified according to vessel type and flow speed. 1 Distinguished are the high-flow arteriovenous malformations, the low-flow capillary, venous, and lymphatic malformations, and combined lesions. Symptoms experienced by patients vary by type and localization and include disfigurement, pain, bleeding, functional impairment, thrombotic complications, and an overall decreased quality of life as compared with the general population. [1][2][3][4][5][6][7] Management of vascular malformations is often challenging and usually requires a multidisciplinary team of specialists. Many nonsurgical

Surgical management of auricular arteriovenous malformations: A literature review

“…In general, the aim of this surgical method is to completely resect the lesion, but partial resections are also used for functional, aesthetic, or safety requirements 5,24,33 . Even though partial resection may improve the symptoms and preserve the auricle, it has a much higher risk of recurrence than complete resection 5,33–36 . A recent study reported that the recurrence rate following partial resection of auricular AVMs was 66.7% (4/6 patients), and 0% (0/6 patients) in full resection patients over a 9.4 years follow‐up 5 .…”

“…Recurrence or deterioration following partial resection is due to hypoxia around the residual lesions, which can stimulate angiogenesis and new supply vessel formation, causing aggressive growth of the residual lesions 1,8,37 . Therefore, partial resection remains controversial as an optimal method for auricular AVMs but can be used in AVMs that cannot be completely resected 5,6,13,33,34 . In partial resection, an adjuvant method has been proposed where the residual lesion is treated with ethanol embolization 36,38 …”

“…5,24,33 Even though partial resection may improve the symptoms and preserve the auricle, it has a much higher risk of recurrence than complete resection. 5,[33][34][35][36] A recent study reported that the recurrence rate following partial resection of auricular AVMs was 66.7% (4/6 patients), and 0% (0/6 patients) in full resection patients over a 9.4 years follow-up. 5 Recurrence or deterioration following partial resection is due to hypoxia around the residual lesions, which can stimulate angiogenesis and new supply vessel formation, causing aggressive growth of the residual lesions.…”

“…1,8,37 Therefore, partial resection remains controversial as an optimal method for auricular AVMs but can be used in AVMs that cannot be completely resected. 5,6,13,33,34 In partial resection, an adjuvant method has been proposed where the residual lesion is treated with ethanol embolization. 36,38 Complete resection is an effective treatment for auricular AVMs to achieve mass elimination 7,39,40 Some scholars believed that resections can be limited to the cartilage level since the EAC is usually not involved, so auricle amputation or partial pinnectomy is used to remove the lesion.…”

Surgical management of bilateral thoracic outlet lymphaticovenous malformations causing recurrent cerebrovascular accidents

“…1 , 9 , 11 , 12 Densely associated tissue growth may require staged debulking with vascular reconstruction in such cases. 1 , 9 , 13 Thus, shared decision-making with the patient is paramount.…”