Vascular Malformations: An Update

Abstract

Vascular malformations occur as a result of an arrest in the development of the vascular system. The modified Hamburg classification distinguishes arterial, venous, arteriovenous, capillary, lymphatic, and mixed vascular malformations. Each malformation is further subdivided based on anatomy and on the time when arrest in development of the embryogenesis occurred; malformations can be truncular or extratruncular. Progress in the last decade in management has been significant because of improvements in open surgical procedures and perfection of percutaneous and hybrid endovascular interventions and devices, such as balloons, stents, and stent-grafts. There has been increasing use of embolization for the treatment of malformations with coils, other particles, glue, or with endovascular placement of occlusive plugs. Absolute alcohol, detergent liquids, or foam have been used for sclerotherapy with improved efficacy. The agents are delivered percutaneously or through a catheter placed either into the feeding arteries or the draining veins. This review aims to aid vascular and endovascular specialists in staying familiar with vascular malformations. These specialists need to be able to evaluate the patients, perform treatment if appropriate, or refer complex cases to multidisciplinary vascular malformation clinics and vascular centers.

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

“…An aneurysmal saphenous vein can be misdiagnosed as a femoral hernia or vice versa. The presence of a longer limb, lateral varicosity noted soon after birth, and associated capillary malformations are tip-offs for congenital venous malformation (Klippel-Trénaunay syndrome), 74,75 whereas edema of the dorsum of the foot, squaring of the toes, thick skin, and nonpitting edema are signs of chronic lymphedema. The physical examination can be complemented by a handheld Doppler examination, although the latter does not replace evaluation of the venous circulation with color duplex scanning.…”

Congenital Anomalies and Malformations of the Vasculature

“…Vascular malformations are further subdivided according to the Modified Hamburg Classification, including a (1) primary classification based on the predominant vascular defect, and (2) an embryological subclassification based on anatomy and the stage of developmental arrest. [88][89][90][91] Vascular malformations can be further divided into groups based on vessel type and flow characteristics. Capillary, venous, and lymphatic malformations are slow-flow lesions, and arteriovenous malformations (AVMs) and fistulas (AVFs) are fast-flow lesions; further combined lesions may also occur.…”

Degeneración sarcomatosa de malformación arteriovenosa Sarcomatous degeneration arteriovenous malformation

“…El tratamiento de las MAV tiene como objetivo el cierre de las comunicaciones arteriovenosas mediante cirugía convencional o técnicas endovasculares. Actualmente, la embolización transarterial de la arteria nutricia es la primera opción terapéutica 7 . Los tumores mesenquimales se presentan como tumoraciones indoloras de crecimiento lento.…”