Management of vascular malformations has evolved overtime to encompass three distinct approaches: the conservative,the minimally invasive, and the operative. Percutaneous interventional management has become widely accepted as the principal minimally invasive therapy for vascular malformations,replacing surgery for many traditional indications.
Nevertheless, many challenging vascular malformations necessitate therapeutic strategies that combine some or all of these approaches. Management of vascular anomalies can be challenging and lengthy; these disorders are extremely heterogenous,affect any body organ or system at any age, and have frequently overlapping presentations.
Arteriovenous MalformationS (AVM), are complex primitive network of connecting channels (nidus) which bypasses the normal capillary bed diverting the Arterial inflow in to draining veins resulting in including tissue ischemia and venous hypertension.
Clinically, AVMs are associated with overgrowth, hyperemia, pulsatility, and pain.In advanced stages, skin and tissue loss, bleeding, and infrequently,high-output heart failure may occur.
Embolization for Arteriovenous Malformations using Embolic Agents which can be Liquid(N-butyl cyanoacrylate glue and ethylene vinyl alcohol copolymer [Onyx] and Solid agents like coils,PVA particles are used . The goal of the embolization is to obliterate the distal feeding arteries and the immediate draining vein.
Venous Malformations (VMs), the most common vascular malformations, manifest typically as solitary lesions with preference for the cervicofacial area, extremities, and trunk. The prime indication for treatment of VMs is pain, which eventually develops in the vast majority of lesions.
Sclerotherapy for Venous Malformations is usually the initial intervention of choice.
LYMPHATIC MALFORMATIONS often flares up with symptoms of Pain, bleeding and leakage of Lymph due to intralesional bleeding and infection.
Sclerotherapy for Lymphatic Malformations is relatively simple technique donefacilitated by US guidance. The lymph is completely aspirated and partially replaced with the sclerosant like Doxycycline,Bleomycin and Ethanol.