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Jiménez-Jiménez CE, Radial Tagliapetra L, Silva-Restrepo IE, Hossman-Galindo MA, Rueda JD, Quiroga Villalobos F. Tratamiento de malformaciones y tumores vasculares, en un centro de referencia en Bogotá. REVISTA COLOMBIANA DE CIRUGÍA 2020. [DOI: 10.30944/20117582.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Introducción. Las malformaciones vasculares son anomalías que están presentes desde el nacimiento, no desaparecen y pueden crecer a lo largo de la vida. Se ha demostrado en estudios retrospectivos que la terminología para clasificar las anomalías vasculares es inexacta en un 69 % de casos, por lo que se hace un diagnostico inadecuado y en un 53 % de casos se brinda al paciente y su familia una información incorrecta del tratamiento y el curso clínico.
Métodos. Estudio prospectivo longitudinal, realizado entre 2016 y 2019, donde se incluyeron pacientes con anomalías vasculares, que consultaron a nuestra institución, fueron valorados por el servicio de cirugía vascular, se hizo un plan diagnóstico y manejo integral, vía endovascular, quirúrgica o mixta, de acuerdo con cada caso.
Resultados. La malformación más común fue la de tipo venoso, en el 40,3 % de los casos. Se realizó manejo endovascular en el 93,1 % de casos de malformaciones vasculares y quirúrgico en el 6,9 %. La mejoría de los síntomas que motivaron la consulta fue del 100 % para los tumores vasculares y del 70,8 % para las malformaciones. Sin embargo, los resultados son heterogéneos.
Discusión. Es necesario realizar un adecuado diagnóstico de las anomalías vasculares, para alcanzar un tratamiento eficaz, con mejoría de los síntomas.
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Song D, Guo L, Sheng H, Li J, Wang L, Wu C, Wang C, Niu Y, Zeng Q. DSA-guided percutaneous sclerotherapy for children with oropharyngeal low-flow venous malformation. Exp Ther Med 2020; 19:3405-3410. [PMID: 32266040 DOI: 10.3892/etm.2020.8581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 11/05/2019] [Indexed: 11/06/2022] Open
Abstract
The present study investigated the efficacy and safety of digital subtraction angiography-guided 3% polidocanol foam sclerosing agent, as well as the combination of pingyangmycin and dexamethasone, for the treatment of children with oropharyngeal low-flow venous malformation. A total of 27 children with 35 lesions with oropharyngeal low-flow venous malformation were included. The subjects were randomly divided into Groups A (13 patients with 16 lesions, treated with 3% polidocanol foam sclerosing agent) and B (14 patients with 19 lesions, treated with pingyangmycin + dexamethasone), respectively. The clinical efficacies and adverse reactions were analyzed and compared between these two groups. The average number of treatment times for Group A was 2.45±0.6, with an efficacy rate of 87.50%, while the average number of treatment times for Group B was 2.07±0.4, with an efficacy rate of 84.21%. No significant difference was found in the average treatment times or efficacy rates between Groups A and B. In addition, the adverse reaction incidence for Groups A and B were 38.46 and 14.29%, respectively, with statistically significant differences between these two groups. The combination of pingyangmycin and dexamethasone was safe and effective in treating children with oropharyngeal low-flow venous malformation, with fewer adverse reactions and is worthy of clinical promotion.
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Affiliation(s)
- Dan Song
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China.,Department of Vascular Anomalies and Interventional Radiology, Jinan, Shandong 250022, P.R. China
| | - Lei Guo
- Department of Vascular Anomalies and Interventional Radiology, Jinan, Shandong 250022, P.R. China
| | - Hui Sheng
- Department of Radiology, Qilu Children's Hospital of Shandong University, Jinan, Shandong 250022, P.R. China
| | - Jing Li
- Department of Vascular Anomalies and Interventional Radiology, Jinan, Shandong 250022, P.R. China
| | - Liang Wang
- Department of Vascular Anomalies and Interventional Radiology, Jinan, Shandong 250022, P.R. China
| | - Changhua Wu
- Department of Vascular Anomalies and Interventional Radiology, Jinan, Shandong 250022, P.R. China
| | - Changfeng Wang
- Department of Vascular Anomalies and Interventional Radiology, Jinan, Shandong 250022, P.R. China
| | - Yanli Niu
- Department of Vascular Anomalies and Interventional Radiology, Jinan, Shandong 250022, P.R. China
| | - Qingshi Zeng
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
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Surgical treatment of Servelle-Martorell syndrome. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2018; 26:301-304. [PMID: 32082751 DOI: 10.5606/tgkdc.dergisi.2018.15358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/14/2018] [Indexed: 11/21/2022]
Abstract
Although the etiology and prognosis are not known precisely, Servelle-Martorell syndrome is often a venous, but rarely an arterial vascular malformation characterized by soft tissue hypertrophy and musculoskeletal hypotrophy of the affected extremity. In general, surgery is the choice in restricted conditions for the treatment of vascular malformations; however, it is unavoidable, if complications occur. These vascular malformations are often treated with medically using compression stockings and drugs. Herein, we present a 20-year-old male patient with Servelle-Martorell syndrome treated with surgically due to venous malformation.
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Ultrasound-guided intralesional diode laser treatment of congenital extratruncular venous malformations: mid-term results. Eur J Vasc Endovasc Surg 2014; 47:558-64. [PMID: 24656873 DOI: 10.1016/j.ejvs.2014.02.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 02/14/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE/BACKGROUND Over the short term, endovenous laser ablation (EVLA) has been found to be safe and effective for endovenous ablation in extratruncular venous malformations (EVMs). We report our experiences in percutaneous ultrasound (US)-guided treatment of congenital EVMs with respect to effectiveness and safety over the mid-term. METHODS This was a retrospective analysis of a collected database of consecutive US-guided intralesional diode laser treatments of congenital EVMs (2007-2013). A consecutive series of 164 patients (86 women/girls [53%] and 78 men/boys [46%], aged 1.5-68.0 years [mean age 20.78 years]) were treated using EVLA for congenital EVMs at our institution. All of the patients were symptomatic. The primary outcomes for assessing safety were mortality and morbidity, including laser-related adverse events, thrombotic events, and important nerve or vessel injuries, and so on. Effectiveness was assessed according to reduction of the mass, the absence of pain, and technical success. RESULTS One hundred and ninety procedures were undertaken in 164 patients, achieving a 100% immediate technical success rate. Most complications were minor and improved quickly, except in one patient, who suffered a peroneal nerve injury. Spot skin burn injuries occurred in one procedure (0.53%). Paresthesia in the treated area was noted after 15 procedures (7.89%). For complaints related to swelling, cosmetic outcomes, and pain, the clinical success rates were 65.71%, 68.97% and 97.74%, respectively. After a mean follow-up of 23.91 months, no patient suffering from pain, hemorrhage, or limited range of motion had returned with recurrent symptoms after initial successful treatment (resolved). Recurrence rates in patients with heavy sensation, swelling, and deformity were 6.89% (two of 29), 7.41% (two of 27), and 11.11% (one of nine), respectively. One hundred and twelve (59.00%) treated lesion areas were classified as "excellent", 59 lesions (31.00%) were "good", and 19 lesions (10.00%) were "fair" using duplex US imaging at the final follow-up visit. CONCLUSIONS EVLA is a minimally invasive treatment with the advantages of safety, effectiveness, and simplicity in ameliorating symptoms associated with EVMs in appropriately selected patients.
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Pföhler C, Janssen E, Buecker A, Vogt T, Müller CSL. Successful treatment of a congenital extra-truncal vascular malformation by orally administered propranolol. J DERMATOL TREAT 2013; 26:59-62. [PMID: 24359542 DOI: 10.3109/09546634.2013.869301] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract The β-blocker propranolol has become a valuable and effective drug for the treatment of infantile hemangiomas. Its therapeutic action probably results from vasoconstriction, blocking of angiogenesis through effects on vascular endothelial growth factor and induction of apoptosis. It is reasonable to suggest that propranolol can also be used effectively in the treatment of other vascular abnormalities. This case report describes propranolol treatment of vascular malformations such as Klippel-Trénaunay syndrome or Parkes-Weber syndrome in adults.
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Wilmanska D, Antosik-Biernacka A, Przewratil P, Szubert W, Stefanczyk L, Majos A. The role of MRI in diagnostic algorithm of cervicofacial vascular anomalies in children. Pol J Radiol 2013; 78:7-14. [PMID: 23807878 PMCID: PMC3693840 DOI: 10.12659/pjr.883941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 01/28/2013] [Indexed: 11/30/2022] Open
Abstract
Background: Vascular anomalies are usually diagnosed through their clinical picture and history. The purpose of this study was to assess the role of MR imaging in initial assessment of cervicofacial vascular anomalies in children. Material/Methods: Twenty pediatric patients with vascular anomalies located in the cervicofacial region underwent MRI examination in our department. Images were evaluated for lesion detectability and its signal characteristics (on T1w, T2w images with fat suppression and contrast enhanced T1w sequences); the extent of the lesions and surrounding tissue involvement were also assessed. Results: In the studied group MR images revealed all anomalies and provided information of their anatomic extent and invasion of surrounding anatomic structures. Nine hemangiomas and six venous malformations were found among studied patients. Two children had multiloculated lesions corresponding to lymphatic malformations. One examination visualized a lesion consisting mainly of dilated vascular channels with an apparent feeding artery, which was consistent with arteriovenous malformation. Two remaining lesions were mixed malformations. Nine patients had lesions limited to subcutaneous tissue. Two masses infiltrated bone structures. There was muscle involvement found in nine cases. Conclusions: MR imaging is a well-established method for detection and monitoring of vascular anomalies in children. With ultrasound used mostly for initial diagnosis and additional flow assessment, angiography viewed as an invasive therapeutic method and computed tomography used only in specific situations due to its high irradiation dose, magnetic resonance is the best imaging method used in differential diagnosis and topographical characterization of vascular malformations and tumors of cervicofacial area in pediatric patients. Noninvasively and without irradiation, it enables evaluation of the extent and characteristics of lesions and planning proper therapeutic strategy.
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Affiliation(s)
- Dagmara Wilmanska
- Department of Radiology and Imaging Diagnostics, Medical University of Łódź, Łódź, Poland
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Lojo Rocamonde I, Moro Mayor A, Barreiro Veiguela J. Malformaciones vasculares periféricas. Diagnóstico y tratamiento. ANGIOLOGIA 2012. [DOI: 10.1016/j.angio.2012.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Yun WS, Kim DI, Rho YN, Do YS, Park KB, Kim KH, Park HS, Kim YW, Park UJ, Kim N, Woo SY. Natural course of venous malformation after conservative treatment. Surg Today 2012; 42:950-5. [PMID: 22535018 DOI: 10.1007/s00595-012-0185-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Accepted: 08/15/2011] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the clinical course of patients with venous malformation (VM) treated conservatively. METHODS We reviewed retrospectively the database of our Congenital Vascular Malformation clinic and interviewed 207 patients with VM, who had been managed only conservatively. The questionnaires asked about changes in size (no change, increase in proportion to growth, increase greater than in proportion to growth, decrease) and changes in symptoms (markedly worse, moderately worse, no change, moderately improved, markedly much improved). Progression of VMs was defined as an increase greater than in proportion to growth or worsening symptoms. RESULTS Fifty patients (24 %) reported an increase in size greater than in proportion to growth and 25 patients (12 %) reported symptoms worsening from their initial symptoms. Overall, sixty-six (32 %) of the patients reported evidence of progression of their VM. A binary logistic regression model identified VM combined with capillary malformation (CM) or lymphatic malformation (LM) as an independent predictor of VM progression (OR 2.67, 95 % CI 1.29-5.53). CONCLUSIONS Based on responses to the questionnaire, the size and symptoms of VM progressed in 32 % of patients over the course of their life. VMs combined with CM or LM were the only independent predictor of progression of a VM after conservative management.
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Affiliation(s)
- Woo-Sung Yun
- Congenital Vascular Malformation Clinic, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea
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Lu X, Ye K, Shi H, Li W, Huang Y, Huang X, Lu M, Jiang M. Percutaneous endovenous treatment of congenital extratruncular venous malformations with an ultrasound-guided and 810-nm diode laser. J Vasc Surg 2011; 54:139-45. [DOI: 10.1016/j.jvs.2010.11.105] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 10/21/2010] [Accepted: 11/13/2010] [Indexed: 10/18/2022]
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Abstract
The aim of this review was to discuss the current knowledge on aetiopathogenesis, diagnosis and therapeutic management of venous malformations (VMs). VMs are slow-flow vascular anomalies. They are simple, sporadic or familial (cutaneomucosal VMs or glomuvenous malformations), combined (e.g. capillaro-venous and capillaro-lymphaticovenous malformations) or syndromic (Klippel-Trenaunay, blue rubber bleb naevus and Maffucci). Genetic studies have identified causes of familial forms and of 40% of sporadic VMs. Another diagnostic advancement is the identification of elevated D-dimer level as the first biomarker of VMs within vascular anomalies. Those associated with pain are often responsive to low-molecular-weight heparin, which should also be used to avoid disseminated intravascular coagulopathy secondary to intervention, especially if fibrinogen level is low. Finally, development of a modified sclerosing agent, ethylcellulose-ethanol, has improved therapy. It is efficient and safe, and widens indications for sclerotherapy to sensitive and dangerous areas such as hands, feet and periocular area.
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Affiliation(s)
- Anne Dompmartin
- Université de Caen Basse Normandie, CHU Caen, Department of Dermatology, Caen (France)
| | - Miikka Vikkula
- Université catholique de Louvain, de Duve Institute, Laboratory of Human Molecular Genetics, B-1200 Brussels, Belgium
| | - Laurence M Boon
- Université catholique de Louvain, de Duve Institute, Laboratory of Human Molecular Genetics, B-1200 Brussels, Belgium
- Université catholique de Louvain, Cliniques universitaires St Luc, Center for Vascular Anomalies, Division of Plastic Surgery, B-1200 Brussels, Belgium
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Yun WS, Kim YW, Lee KB, Kim DI, Park KB, Kim KH, Do YS, Lee BB. Predictors of response to percutaneous ethanol sclerotherapy (PES) in patients with venous malformations: Analysis of patient self-assessment and imaging. J Vasc Surg 2009; 50:581-9, 589.e1. [PMID: 19540703 DOI: 10.1016/j.jvs.2009.03.058] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 03/25/2009] [Accepted: 03/26/2009] [Indexed: 01/19/2023]
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Maftei N, Howard A, Brown LC, Gunning MP, Standfield NJ. The surgical management of 73 vascular malformations and preoperative predictive factors of major haemorrhage--a single centre experience. Eur J Vasc Endovasc Surg 2009; 38:488-97. [PMID: 19660969 DOI: 10.1016/j.ejvs.2009.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Accepted: 06/20/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVES In our series of patients with congenital vascular malformations (CVMs) we investigate the preoperative factors for predicting major haemorrhage at surgery and propose an algorithm for their surgical management. DESIGN This is a partly prospective case series of patients with severe symptoms/complications due to CVMs. MATERIALS AND METHODS Data were collected on 73 consecutive procedures in 41 patients with CVMs from 1992 to 2006 at a large university hospital and the association of following factors with blood loss during the procedure were investigated: type of procedure, possibility of proximal tourniquet use, lesion flow characteristics, previous history of major haemorrhage with CVM surgery, platelet counts and length of hospital stay. RESULTS Significantly higher blood loss was associated with debulking surgery (p=0.006) and with previous history of major haemorrhage during CVM surgery, (p=0.041). Blood loss was higher in lesions where proximal tourniquet application was not possible (p=0.093). High-flow lesions were not strongly associated with major blood loss (p=0.288). Major blood loss (>2l) occurred in 16 (20.8%) procedures performed on 11 (26.2%) patients, but this did not prolong hospital stay. CONCLUSION Surgery can potentially improve morbidity/mortality in patients with life/limb-threatening complications or severe symptoms due to CVMs, providing they are managed in multidisciplinary specialised centres.
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Affiliation(s)
- N Maftei
- Charing Cross Hospital, Imperial College Healthcare NHS Trust, Department of Vascular Surgery, London, UK.
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