Ces radiol. 2008, 62(2):131-145

Diagnosis and management of low-flow veno-lymphatic vascular malformationsReview article

Wayne F. Yakes

Vascular Malformation Center

Venous malformations pose some of the most difficult challenges in the practice of medicine today. Clinical manifestations of these lesions are extremely protean. Because of the rarity of these lesions, experience in their diagnosis and management by most clinicians is limited. This augments the enormity of the problem and can lead to misdiagnoses, inadequate treatment, high complication rates, and poor patient outcomes. Vascular malformations are best treated in medical centers where patients with these maladies are seen regularly and the team approach is utilized. The occasional embolizer will never gain enough experience to adequately treat these problematic lesions. More importantly, when complications do occur, the morbidity of that complication is worsened because of this lack of experience and absence of an experienced team of physicians. All too frequently the patient will ultimately pay for a physician's initial enthusiasm, inexperience, folly, and lack of necessary clinician backup. A cavalier approach to the management of venous malformations will always lead to significant complications and dismal patient outcomes. These patients should be referred to centers that regularly treat vascular malformations, manage the complications that occur appropriately and in a timely manner, and routinely deal with the dilemmas they present. Only in this fashion can significant experience be gained, improved judgment in managing these lesions develop, and definitive appropriate statements in the treatment of vascular anomalies evolve.

Keywords: embolization, ethanol, vascular malformations, veno-lymphatic vascular malformations, venous vascular malformation

Accepted: March 31, 2008; Published: June 1, 2008  Show citation