Vascular anomalies of the upper limb

Abstract

Vascular anomalies are common in the upper extremity but there is a relative paucity of information about them in the hand and upper limb surgical literature. The wide spectrum of pathology and an inconsistent use of terminology make vascular anomalies susceptible to incorrect diagnosis and as a result to misdirected management. This article aims to provide an update on vascular anomalies relevant to the upper limb, focusing on significant advances in pathogenesis and genetics, classification systems, diagnosis and treatment.

Knockdown of slit signaling during limb development leads to a reduction in humerus length

“…Defects in blood vessel development can also influence bone development 47,48 . For example, in Vegfa 120/120 mice, which express only the VEGFA 120 isoform, lengths of long bones are reduced 49,50 .…”

“…Defects in blood vessel development can also influence bone development. 47,48 For example, in Vegfa 120/120 mice, which express only the VEGFA 120 isoform, lengths of long bones are reduced. 49,50 It is unclear whether Slit/ Robo signaling acts as an attractant or repellent to endothelial cell migration, 19,51,52 however functioning as an attractant to endothelial cell growth during bone development would explain reduced limb cartilage elements upon neutralization of Slit signaling.…”

Posttraumatic Vascular Anomalies in Hand Surgery—A Case-based Approach

“…The current literature seems to focus on extraordinary VA cases in the world’s biggest centers. 6 Indeed, clinicians are confronted with VA, without realizing that the most common VA, the PG, has been known for more than a century in general surgical practice. 10 In contrast to congenital VA, posttraumatic VA is much more common.…”

“… 3 , 4 Usually, this topic is limited to the very last pages in hand surgery text books, 5 and is given little attention. Furthermore, if the topic is considered at all, it usually focuses on the rare cases treated in the world’s largest centers 6 without sharing the experience of the more general scientific community. These cases mostly reflect congenital anomalies and, to a lesser degree, posttraumatic lesions of the hand or the extremities.…”