Vascular Malformations: Advances and Controversies in Contemporary Management

Description

This new book on vascular malformations brings together international experts to present advances and discuss controversies in the multidisciplinary management of patients with congenital vascular malformations. Major advances in recent years in medical genetics, and tremendous progress in the fields of imaging and minimally invasive percutaneous interventions have revolutionized both evaluation and management of vascular malformations. The six major parts of this state of the art book ensure that the reader has the most up to date valuable clinical information to ensure the delivery of world class clinical practice. Beautifully illustrated with color line drawings, numerous photographs and informative tables, the advances and controversies of the full spectrum of vascular malformations are presented in 90 definitive chapters. Vascular Malformations brings new information and unparalleled insights to vascular specialists and physicians, trainees and allied health professionals who participate in the care of patients with vascular malformations, either in a private practice setting or at a major institution in an interdisciplinary vascular center. Cover......Page 1 Half Title......Page 2 Title Page......Page 4 Copyright Page......Page 5 Contents......Page 6 Preface......Page 12 Foreword......Page 14 Contributors......Page 16 Part 1: Congenital Vascular Malformations (CVMs) in General......Page 20 Section 1: Definition and Classification......Page 22 1. ISSVA classification: Controversy with the benefit and liability......Page 24 2. Hamburg classification: Controversy with the benefit and liability......Page 26 3. Syndromic classification of congenital vascular malformations: How useful is it?......Page 30 4. Consensus on contemporary classification......Page 34 Section 2: Diagnosis......Page 38 5. How extensive study should be included in initial assessment for congenital vascular malformations......Page 40 6. Should hemangiomas be included in initial differential diagnosis for congenital vascular malformations?......Page 44 7. To what extent should genetic studies be incorporated for assessment of venous and arteriovenous malformations, and when?......Page 50 8. Indications for genetic testing in evaluation of lymphatic and hemolymphatic malformations......Page 54 Section 3: Management......Page 56 9. Importance of interdisciplinary team approach for evaluation and management of vascular malformations......Page 58 10. How will genetics influence management of vascular malformations?......Page 62 Part 2: Arteriovenous Malformations (AVMs)......Page 70 Section 4: Definition and Classification......Page 72 11. Confusion with arteriovenous fistula versus arteriovenous malformation of ISSVA classification......Page 74 12. Nidus or no nidus: Is it a crucial issue for diagnostic assessment of arteriovenous malformations?......Page 78 13. New classification of arteriovenous malformations based on angiographic findings: What are the advantages?......Page 82 Section 5: Diagnosis......Page 86 14. Arteriographic assessment: Is it still the gold standard for diagnosis of arteriovenous malformations?......Page 88 15. Ultrasonographic assessment: New role for arteriovenous malformations. How far can it be implied?......Page 92 16. Magnetic resonance angiography and/or computed tomography angiography: New gold standard for arteriovenous malformations?......Page 96 17. Transarterial lung perfusion scintigraphy (TLPS): New role for follow-up assessment?......Page 100 Section 6: Management: 1......Page 102 18. Do all the arterio-venous malformations mandate the therapy? Is there any contraindication for the therapy?......Page 104 19. How much is too much for arteriovenous malformation management?......Page 108 20. Ethanol sclerotherapy: Is it gold standard for arteriovenous malformation management?......Page 114 21. N-butyl cyanoacrylate versus Onyx embolotherapy......Page 118 Section 7: Management: 2......Page 124 22. Surgical therapy combined with embolo-/sclerotherapy: Multidisciplinary approach......Page 126 23. Indications for amputation in patients with arterio-venous malformations......Page 130 24. How much pharmacological therapy can be incorporated into arteriovenous malformation management?......Page 134 25. Secondary changes in arteriovenous malformations: Arteries, veins, tissues, bones, when do they have to be treated?......Page 136 Part 3: Venous Malformations......Page 138 Section 8: Definition and Classification......Page 140 26. Capillary and cavernous hemangioma and venous malformations......Page 142 27. Angiographic classification of venous malformations based on venous drainage status: What are the advantages?......Page 146 Section 9: Diagnosis......Page 150 28. Ultrasonographic assessment: Mandatory test to lead the assessment of the venous malformations?......Page 152 29. Conventional and dynamic contrast enhanced magnetic resonance imaging (dceMRI) and/or magnetic resonance venography: Diagnostic modalities with different objectives? Can they replace phlebography?......Page 156 30. Computed tomography (CT) and CT venography: How are these diagnostic modalities different from magnetic resonance imaging (MRI) for evaluation of venous malformations?......Page 160 31. Whole-body blood pool scintigraphy (WBBPS): Special role for management of venous malformations?......Page 162 Section 10: Management: 1......Page 166 32. Do all venous malformations require treatment?......Page 168 33. How much is too much for venous malformation management?......Page 172 34. What is the first option for venous malformation management?......Page 176 35. Ethanol sclerotherapy: Is it gold standard for venous malformation management as well?......Page 182 36. Foam sclerotherapy: First option for venous malformations?......Page 184 37. Considerations regarding feasibility, safety, and efficacy of N-butyl cyanoacrylate (n-BCA) and Onyx embolization for the treatment of venous malformations......Page 186 Section 11: Management: 2......Page 188 38. Surgical therapy of venous malformation combined with embolo-/sclerotherapy: How much and when?......Page 190 39. How aggressive should management be of vascular bone syndrome caused by venous malformation?......Page 194 40. To what extent should anticoagulation therapy be considered for venous malformations?......Page 198 41. How to approach treatment of marginal vein combined with deep vein hypoplasia/aplasia?......Page 202 42. Indications for amputation in patients with extensive venous malformations......Page 206 43. How much pharmacological therapy can be incorporated in venous malformations management?......Page 210 Part 4: Lymphatic Malformations......Page 214 Section 12: Definition and Classification......Page 216 44. Confusion on terminology: Primary lymphedema and lymphangioma (lymphatic malformation)......Page 218 45. Contemporary diagnosis of primary lymphedema and lymphatic malformation......Page 222 46. Clinical staging of lymphedema: How practical is it for clinical management of primary lymphedema?......Page 226 47. Laboratory (lymphoscintigraphic) staging guideline?......Page 230 Section 13: Diagnosis......Page 234 48. Ultrasonographic assessment of lymphatic malformations—Lymphangioma and primary lymphedema: A new role for diagnosis?......Page 236 49. Radionuclide lymphoscintigraphy—Gold standard for assessment of lymphatic malformation: Lymphangioma and primary lymphedema or both?......Page 240 50. Magnetic resonance imaging and magnetic resonance lymphangiography of primary lymphedema: A new gold standard?......Page 244 51. Indocyanine green fluorescent lymphography: Clinical implementation......Page 248 52. Oil contrast lymphangiography: New role for the surgical candidate?......Page 252 53. Fluorescent microlymphangiography: Controversy, confusion, and neglected problems......Page 258 54. Can indocyanine green replace role of lymphoscintigraphy?......Page 262 55. How to differentiate between lymphedema and lipedema: How to rule out lipedema......Page 264 Section 14: Management: 1—Primary Lymphedema......Page 268 56. Manual lymphatic drainage: Myth?......Page 270 57. Compression therapy: Optimal pressure? Bandage versus stocking......Page 274 58. Sequential intermittent pneumatic compression: Rationale? How much can it be incorporated into compression therapy?......Page 280 59. Reconstructive surgery: Lymphovenous anastomosis versus lymph node transplantation—Can they stay as independent therapy options?......Page 284 60. Excisional surgery: When and how much it can be incorporated......Page 290 61. Multidisciplinary approach with liposuction in primary lymphedema: Is there a difference compared to patients with secondary lymphedema?......Page 292 62. How much pharmacological therapy can be incorporated in primary lymphedema management?......Page 298 63. What is difference in management of primary lymphedema between adults and children, and how much?......Page 302 64. How to manage lipedema involved with primary lymphedema?......Page 306 65. How to assess response/efficacy of manual lymphatic drainage and compression therapy......Page 308 66. How to assess efficacy of lipedema management involved in lymphedema......Page 312 67. Pathophysiology behind adipose tissue deposition in lymphedema and how liposuction can completely reduce excess volume......Page 316 68. Liposuction: Can it be applied to management of lipedema?......Page 324 Section 15: Management: 2—Lymphangioma......Page 328 69. How to manage lymphatic leakage involved in lymphangioma?......Page 330 70. How to manage recurrent infections involved with lymphangioma?......Page 334 71. How should aggressive chyloreflux (e.g., chyluria, chyloascites, chylothorax, chyle leakage) be handled?......Page 338 72. Pharmacological considerations for lymphatic malformation management......Page 344 73. How much different should the management of lymphangioma among the pediatric/neonatal age group be?......Page 346 74. Peculiarities in surgical treatment in childhood: Can we ignore?......Page 350 Part 5: Combined vascular malformations: Hemolymphatic malformations/Klippel–Trenaunay syndrome......Page 354 Section 16: Diagnosis......Page 356 75. To what extent should diagnostic study be extended for assessment of arteriovenous malformation involvement in Klippel–Trenaunay syndrome?......Page 358 76. How much should diagnostic investigations incorporate visceral involvement for Klippel–Trenaunay syndrome?......Page 362 Section 17: Management: 1......Page 366 77. How to decide priority for treatment among congenital vascular malformation components......Page 368 78. Management of vascular bone syndrome: How aggressive and when?......Page 372 79. How aggressively should varicose veins be managed in Klippel–Trenaunay syndrome?......Page 380 80. How aggressive should management be of indolent stasis ulcer in Klippel–Trenaunay syndrome?......Page 384 Section 18: Management: 2......Page 386 81. How should aggressive gastrointestinal bleeding in Klippel–Trenaunay syndrome be handled?......Page 388 82. Therapeutic considerations for infection, sepsis, and lymphatic leak management in patients with Klippel–Trenaunay syndrome......Page 390 83. How to manage coagulopathy in Klippel–Trenaunay syndrome?......Page 392 84. Klippel–Trenaunay syndrome: Pain and psychosocial considerations......Page 396 85. Klippel–Trenaunay syndrome and complex venous malformations: Should multimodality approach be standard of care?......Page 400 Part 6: Capillary Malformations (CMs)......Page 406 Section 19: Diagnosis......Page 408 86. Is this capillary malformation? Differential diagnosis and other dermal vascular lesions......Page 410 87. How much diagnostic assessment for port-wine stains should be extended for other vascular malformations to exist together?......Page 416 Section 20: Management......Page 420 88. Port-wine stains/capillary malformation among patients with Klippel–Trenaunay syndrome: How to select candidate for laser therapy and when......Page 422 89. To what extent should surgical excision be implemented to port-wine stains, and when?......Page 426 90. To what extent could laser therapy and surgical excision be combined for port-wine stain management?......Page 428 Epilogue......Page 430 Index......Page 432