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Vascular Malformation Treatment

What are vascular malformations?

Vascular Malformations are defects of circulatory system which develop when baby is in mother womb (fetal life) or soon after birth. They have either increased number of veins/abnormal connections between arteries & veins / mal-developed vein, lymphatic.

Why do they develop?

Usually occurs due to problems in the formation and development of the veins, arteries or lymphatics during pregnancy. It can also occur due to some genetic abnormalities in child or family.

What are the types?

  • Venous Malformations
  • Arterio-venous malformations(AVM)
  • Lymphatic/ lymphovenous malformation
  • Mixed malformation
  • How do they look like?

    They appear as bluish-purple coloured swellings on any part of body. If it’s deep can have normal skin colour.
    Commonly seen areas are face & neck, arms or thighs, back.
    As the child grows, it increases in size. In rare cases, it might appear after teenage or in adulthood.

    What are the complications if proper treatment is not taken? Why are vascular malformations dangerous?

  • Skin ulcers & infection
  • Blood clot formations
  • Bleeding from malformation
  • Severe disfigurement of body part/Need for limb amputation (rare)
  • How can we diagnose a vascular malformation?

    Your vascular surgeon can come to diagnosis by doing few investigations – Ultrasound/CT scan/MRI.

    How can I help my child if I am suspecting a vascular malformation?

    Your child needs detailed evaluation by a qualified vascular surgeon who has expertise in managing vascular malformations.

    Patient MRI 1
    Patient MRI 1

    What are the treatment options?

    Treatment depends on type of the vascular malformation & age of the patient.
    Malformations with arterial component needs aggressive treatment & they’re known to occur again.
    Treatment options include:

     

    1. Observation-Small lesions are often watched over time. Treated if they increase in size or cause problems.
    2. Sclerotherapy– Used mainly for venous malformations.
      Injecting medicine directly into the malformation under ultrasound/ cathlab guidance, to shrink or close the abnormal veins.
    3. Embolization– Used mainly for arterio-venous malformations (AVMs).
      This procedure blocks blood supply to specific area of AVM, without affecting blood supply of surrounding normal area.
      By doing a small puncture in artery, guide wire along with catheter is introduced into artery & threaded up to particular branch supplying AVM. Special granules/medication are injected here to block the blood supply of AVM.
      AVM gradually shrinks in size due to absence of blood flow.
      Duration of procedure is 1 to 2 hours. You have to remain admitted in hospital for total 12 to 18 hours.
    4. Surgical removal of vascular malformation
    Vacular Malformation of scalp
    patient CT Scan 1
    patient CT Scan 2
    Pre operation
    Post operation