Vascular anomalies - diagnosis and therapy

OBJECTIVE: Vascular anomalies were once thought to be impossible to properly diagnose and treat. Hence, we aimed to evaluate the different diagnostic and therapeutic modalities in the management of vascular anomalies.

METHODS: We carried out a retrospective review of our experience to evaluate different diagnostic and therapeutic modalities in the management of 25 patients with vascular anomalies over a 2-year-period at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia and follow-up period ranging from 2 months to 2 years.

RESULTS: Vascular anomalies were more common in male patients (N=19). Age range was 7 to 46 years. Vascular anomalies were categorized as hemangioma (N=2) or malformation (N=23). The vascular malformation were further subdivided into slow flow (N=5) and fast flow (N=18). Duplex (N=12) and radiographic studies; angiography (N=21), venography (N=7), computerized tomography (N=10) and magnetic resonnance angiography (N=8) were used to confirm diagnosis. The treatment of hemangiomas were surgical resection (N=1) and conservative treatment (N=1). Embolization was the main modality of treatment in vascular malformation (N=16), with surgical resection in 4 patients, sclerotherapy in one and conservative in the other 2. All cases had successful outcome with no complications.

CONCLUSION: Control of large vascular malformations with acceptable results can be achieved nowadays. Intra-arterial embolization is the mainstay of treatment and long term follow-up with serial physical examination, duplex and arteriography is required.