Percutaneous Treatment of Peripheral Vascular Malformations

Vascular malformations arise from errors in the morphological processes that shape the embryonic vascular system during fetal development. These developmental errors result in abnormal clusters of blood vessels. Although these lesions are present at birth, they might not become visible until weeks or even years after birth. Typically, the lesions grow in proportion to the growth of the child. A vascular malformation will not disappear without treatment. Vascular malformations occur in 1.5% of the population and the male to female ratio is 1:1. The symptoms can vary, and they include cosmetic complaints, tissue ulceration, pain, swelling, and functional limitations. In some patients the symptoms are mild, in which case conservative measures might be sufficient. In contrast, patients with severe symptoms might require more invasive treatment. Surgery, interventional radiology, laser therapy or a combination of techniques are used in the treatment of vascular malformations. However, as a result of their rarity, the correct diagnosis and treatment of vascular malformations is difficult, because most physicians do not see these problems often enough to become knowledgeable about their management. For the purpose of this review we performed a literature search to outline the classification, pathogenesis and histological findings, clinical presentation, and treatment of peripheral vascular malformations. We used the PubMed and MeSH databases for the literature search. The following MeSH terms were used: vascular malformations, haemangioma, and arteriovenous malformations, with the subheadings: classification, aetiology, genetics, surgery, and therapy. A specific time interval, 1960 to 2010, was used. In addition, we included in the search the names of groups of investigators who are known to be associated with the different topics and reference lists from other review articles on the same topics. We limited our search to only peripheral vascular malformations and excluded supratentorial and spinal vascular malformations, as well as those of the abdominal and thoracic organs. We focused on publications that described the classification, pathogenesis and genetics of the condition, and non-interventional radiology treatments. This identified a total of 110 publications. The use of an additional database did not reveal any other publications.