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Vascular Malformation
How do I find out of I have one of these vascular malformations?
These can often be seen on physical examination. Deeper vascular malformations can be diagnosed on MRI (magnetic resonance imaging).
How are these malformations treated?
Although surgery is sometimes useful, it is usually difficult for surgeons to completely remove vascular malformations, which will return if not removed completely. A nonsurgical method of closing down the blood or lymph flow into the malformation is done by interventional radiologist & vascular surgeons, who treat patients with image guided procedures. Vascular malformations are treated by embolization & sclerotherapy.
The AVMs and hemangiomas can be closed by advancing a tiny plastic tubing, no larger than a pencil point, into the feeding artery to the malformation. This can be done without incisions or stitches, and with only mild sedation. Medical glue or alcohol or small beads are then floated into the malformation until it is full and no longer has blood flowing through it. For Pulmonary AVMs platinum coils are used to block flow through the feeding artery to the malformation.
The VMs and LMs are closed by injecting sclerosants into the sacs filled with venous blood or lymph until these sacs collapse and no longer fill.
What is the recovery time for the procedure?
The arteriovenous malformations can be treated with a one night hospital stay. There is usually minimal discomfort for one to three days.
The venous and lymphatic malformations also require one night in the hospital. These malformations swell after treatment with sclerosant, and the swelling and pain may last for 3-5 days. During this time, we give patients medication for any pain or swelling they may have. The full shrinkage of these malformations may take four to six weeks.
How effective is the treatment?
Pulmonary arteriovenous malformations are very effectively treated by embolization which blocks only the abnormal artery feeder, and preserves the normal lung arteries. Patients usually notice an immediate improvement in symptoms with the immediate increase in oxygen level.

Other arteriovenous malformations are more difficult to treat since they tend to pull in new artery feeders from time to time. However, embolization is very effective in blocking abnormal artery feeders while preserving normal arteries. AVMs may require a series of treatments to block all of the abnormal feeders.

Venous and lymphatic malformations respond well to alcohol embolization. These may also require a series of treatments about 6 weeks apart to block all of the abnormal vessels.

All vascular malformations require long term surveillance, so that if there is any change, such as a growth spurt with puberty or pregnancy or menopause, they can be monitored for symptoms that may warrant rechecking and possibly retreating. We monitor PAVMs over time to be sure they collapse and do not refill.
How new is this technique?
Embolization techniques have been used extensively all over the world for the past 30 years. They have been well established for many years, and have proved invaluable in treating vascular malformations. However, since congenital vascular malformations are relatively rare, it is probably advisable to obtain treatment at a major center that sees many patients.
What is the best age to have treatment?
We can treat any age from newborn to adult. The best age of treatment depends on the specific vascular malformation and its symptoms, and is best individualized to each person.
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