Hemangiomas and other Vascular
A congenital vascular malformation is a kind of birthmark or congenital growth involving blood vessels. Sometimes the malformation presents nothing more than a cosmetic issue; other times, the malformation is deeper and can cause serious medical problems.
There are a number of different sub-types of vascular malformations, depending on the predominant channel abnormality. These include:
- Capillary malformations (portwine stains)
- Lymphatic malformations (sponge-like collection of abnormal channels and cystic spaces that contain clear fluid)
- Arteriovenous malformations (a connection between the veins and arteries)
- Combined vascular malformations (involves two or more types of vessel abnormalities)
How are vascular malformations diagnosed and treated?
Correct diagnosis and treatment of vascular malformations are crucial.
The first step in evaluating patients involves a history, physical and diagnostic imaging. Dr. Mussman may use MRI and MR angiography for the diagnosis of vascular anomalies.
The most common vascular anomalies treated by Dr. Mussman are hemangiomas, venous and arteriovenous malformations, and lymphatic malformations. Some malformations, like capillary hemangiomas, go away on their own when the child is between 7 and 10 years. Others, like port-wine stains, should be treated because they may be associated with underlying disease.
If left untreated, port-wine stains can cause vascular blebs, or nodules, that can bleed significantly. Port-wine stains on the forehead or eyelids may be linked to Sturge-Weber Syndrome, a congenital neurological disorder. Infants with port-wine stains in those areas should be thoroughly evaluated. A series of laser treatments can begin as early as the first two weeks of life for small port-wine stains or hemangiomas.
Arteriovenous malformations (AVMs) generally appear during adolescence. Most AVMs extend into deep tissue, making surgery impossible, but require treatment.
Treatment for vascular malformations involves stopping or reducing the blood supply by injecting medication into the area. Large venous malformations require a series of injections.
For extensive malformations that are operable, like superficial arteriovenous malformations and benign lesions that interfere with function, surgical resection is usually performed. Prior to surgery, a combination of nonsurgical therapies may be used to decrease blood flow to the lesion or reduce its size.