ENDOVASCULAR MANAGEMENT OF VASCULAR MALFORMATIONS

WHAT ARE VASCULAR MALFORMATIONS AND THEIR TYPES?

Vascular malformations are abnormal clusters of blood vessels, which are present since birth, but manifest at varying ages. In addition to being classified by predominant abnormality, vascular malformations are categorized as either slow flow or fast flow. These terms refer to the rapidity of blood flowing through the lesion. Arteriovenous malformations are fast-flow lesions. Capillary, lymphatic, and venous malformations are considered slow-flow lesions. Combined malformations may be either slow or fast flow.

SYMPTOMS OF VASCULAR MALFORMATIONS

Vascular malformations which are superficial present as swelling underneath the skin causing bluish/ greenish discolouration. They may sometimes cause bleeding and ulcer formation. Vascular malformations which are deep inside may produce pain as a symptom which is aggravated especially by activity. High flow malformations cause pulsations, pain, ringing in the ears (if present in the head) and severe bleeding if they are superficial.

NONSURGICAL TREATMENTS FOR VASCULAR MALFORMATIONS:

VENOUS MALFORMATIONS, LYMPHANGIOMA

These lesions are difficult to treat by surgery alone. Interventional radiologist can do nonsurgical treatment for these lesions. The slow flow venous malformations and lymphangiomas are treated by injection of a drug called sclerosant under ultrasound guidance. The injection can reduce the size of the malformation and helps in shrinking of the lesion.

ARTERIORVENOUS MALFORMATIONS

The high flow vascular malformations such as arteriovenous malformations are difficult to treat by surgery alone. Endovascular embolisation helps in treating arteriovenous malformations. Embolization is a procedure done by interventional radiologist, in which he injects vessel blocking agent into the vascular malformation. Embolization helps in reducing the vascularity of the lesion and thereby helps the surgeon in removing the malformation without much complications and blood loss. Embolization is performed by inserting small tubes ( called micro catheters) into the malformation and injecting blood vessel blocking drug. It is usually done local anaesthesia without any need for skin cuts or sutures.