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Vascular Malformation
Introduction of Vascular Malformation...
What is a vascular malformation?
Vascular Malformation is a general term that includes congenital vascular anomalies of only veins, only lymph vessels, both veins and lymph vessels, or both Arteries and Veins
Classification of Vascular Anomalies
Vascular anomalies are divided into two groups:
A. Tumors e.g. hemangiomas
B. Vascular malformations.
Malformations are categorized according to type and flow
characteristics. 1)High-flow vascular anomalies include arteriovenous fistula channel
(AVF) and arteriovenous malformations (AVM).
2) Low-flow malformations include capillary malformations (CM), venous malformations (VM) and lymphatic (LM) malformations.
Some patients have combined channel anomalies (e.g. Klippel–Trenaunay syndrome (CLVM)).:
Venous malformations (VMs)
may cause pain where ever they are located. Venous and lymphatic malformations may cause a lump under the skin. There may be an overlying birthmark on the skin. Bleeding or lymph fluid leaking may occur from skin lesions. Lymphatic malformations tend to become infected, requiring repeated antibiotic treatments. Venous and lymphatic malformations may be associated with a syndrome called Klippel-Trenaunay Syndrome.
Arteriovenous malformations (AVMs)
may cause pain. They are also more stressful on the heart because of the rapid shunting of blood from arteries to veins. Depending on their location, they may also result in bleeding (for example from the bowels, from the uterus, from the bladder).
Pulmonary arteriovenous malformations (PAVMs) are somewhat different in that they shunt blood from the right heart system to the left heart system without picking up oxygen in the lungs. This results in symptoms of low oxygen, shortness of breath, fatigue. These malformations may also bleed, resulting in coughing up blood or blood in the chest. Also, these pulmonary artery to pulmonary vein shunts can allow clots to pass through the lungs and travel to the arteries in the body, with risk for stroke or brain abscess. This is a very significant reason to block these shunts in anyone who has a non inherited pulmonary arteriovenous malformation (PAVM) or anyone who has inherited PAVMs with the syndrome of HHT (Hereditary Hemorrhagic Telangiectasia) [HHT has another name: OWR – Osler Weber Rendu]
Hemangioma is another common term used for vascular anomalies. However, this name actually applies to a childhood vascular anomaly that has a rapid growth phase between birth and 3 months of age. These will resolve completely by age 7. The major reason for us to treat these is for low platelets that do not respond to medical treatment, or in the liver because of massive shunting with a strain on the heart.
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