Venous malformations: clinical diagnosis and treatment

Abstract

Venous malformation (VM) is the most common type of congenital vascular malformation (CVM). They are present at birth and are often symptomatic, causing morbidity and pain. VMs can be challenging to diagnose and are often confused with hemangioma in terminology as well as with imaging. An accurate clinical history and cross-sectional imaging are critical for diagnosis and for devising management. This manuscript will review imaging approaches to diagnosing VMs and current treatment strategies.

A Rare Case of Superior Vena Cava Saccular Aneurysm

“…Truncal venolymphatic malformations are thought to arise sporadically in most cases, but rare familial inheritance patterns do exist. 6 Such lesions are often present from birth and grow dramatically during times of hormone excess, 6 as in our recently pregnant patient. When these truncal lesions become large and aneurysm has formed, surgical resection is often the treatment modality of choice because these anomalies have a low chance of recurrence after resection.…”

“…Diagnosis often involves advanced imaging, including chest radiography, ultrasonography, chest CT scan, magnetic resonance imaging, venography, or aortography. 6 Potential complications of major venous aneurysms include thrombosis, pulmonary emboli, venous obstruction, and rupture. 2 Complications rarely occur with fusiform aneurysms, whereas saccular aneurysms can be more problematic.…”

“…Thus, aspirin therapy has been recommended as the anticoagulant modality of choice for reduction of thrombotic events in patients without evidence of thrombus formation. 3,6 When thrombus is present, the treatment plan should reflect standardized protocol, weighing risks and benefits concerning the initiation of anticoagulation. Our patient developed a symptomatic pulmonary embolism, so we chose apixaban for further clot prevention, with a good result.…”

Downregulation of lysyl oxidase in venous malformations: Association with vascular destabilization and sclerotherapy

“…3 Clinically, sclerotherapy, alone or in combination with surgery, is the mainstay therapy modality for VM, and bleomycin is widely used to treat VM as an effective sclerosant. 4 However, current treatment options are rarely curative and regrowth is common. 5 Therefore, deeper exploration of the pathogenesis of VM is urgently warranted for development of novel therapeutics.…”

Treatment of Low-Flow Vascular Malformations of the Extremities Using MR-Guided High Intensity Focused Ultrasound: Preliminary Experience

“…Venous malformations represent the most common type of vascular malformation, with an incidence of 1 in 10,000 persons and a prevalence of 1% (2). Injection of a sclerosant agent is a widely accepted first-line treatment of low-flow venous malformations (3).…”