Venous malformations: Clinical course and management of vascular birthmark clinic cases

Abstract

Given the frequent association of VM with other vascular lesions, considerable morbidity, and specialised treatment, a multidisciplinary approach to their management in childhood is important and should include dermatology, diagnostic and interventional radiology, haematology, paediatric surgery, physiotherapy and social services.

Localised intravascular coagulation complicating venous malformations in children: Associations and therapeutic options

“…They constitute over half of all vascular anomalies, with an approximate prevalence of 1% in the general population . VMs may be solitary or multiple, discrete or diffuse, may present anywhere within the body and can cross multiple tissue planes . VMs may occur alone or in combination with lymphatic, capillary and/or arterio‐venous malformations and may be a part of named syndromes including PIKC3A Related Overgrowth Spectrum, Klippel‐Trenaunay Syndrome and Maffucci's Syndrome …”

“…The latter may also be triggered by interventions . This highlights the need for long‐term monitoring of the coagulation profile as well as screening for the possible adverse effects such as pulmonary hypertension, along with judicious anti‐coagulant therapy for LIC in certain circumstances …”

“…Over time, intra‐lesional thrombi develop into phleboliths that may be palpable as hard lumps. Haemorrhage into adjacent tissues or joints may also result in significant pain and swelling . Strategically situated VMs, particularly those associated with LIC, may bleed into the oral cavity, joints, gastrointestinal tract or internal organs, requiring urgent treatment, however this is rare .…”

“…Lifestyle changes to avoid exacerbating activities are not easy to recommend in children. Compression therapy theoretically decreases LIC by limiting blood pooling in the VM . Graduated compression garments are particularly useful in limb VMs as they may provide symptomatic relief by delaying the progression of pain, expansion and ulceration.…”

Gefäßanomalie in der Wangenregion eines Säuglings – Diagnostischer Prozess anhand einer Kasuistik

“…Auch wenn in einer Kohorte von 128 Patienten mit VM die meisten Läsionen (64 %) bereits bei Geburt beobachtet wurden, so war der durchschnittliche Diagnosezeitpunkt deutlich später (nach dem 5. Lebensjahr) und das Gesicht war lediglich in 1/5 der Fälle betroffen [13]. In der Literatur finden sich somit keine Daten über derart früh im Säuglingsalter wachsende VM, die die o. g. Klassifikationskriterien einschließlich Topografie in der Wange erfüllen.…”