Article Text

VASCULAR ABNORMALITIES: EXPERIENCE OF A MULTI-DISCIPLINARY TEAM
  1. J L Cuervo1,
  2. S Tonini2,
  3. B S Viola2,
  4. W Joaquin2,
  5. A Fainboim2,
  6. G Eiselle3,
  7. E Galli3,
  8. M Moreno1,
  9. A Alvarado3,
  10. D Simonelli3
  1. 1Surgery Department, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina
  2. 2Polivalent Outpatients Hospital, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina
  3. 3Hemodynamics Department, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina

Abstract

Objective The term vascular abnormalities (VAs) covers a wide range of blood vessel lesions approached from the interface of several medical disciplines. Our purpose is to present our experience in multi-disciplinary management.

Methods We performed a descriptive and retrospective study of VAs assessed between June 2005 and June 2007. We used ISSVA classification. We analyzed sex, symptoms, age of beginning, therapeutic choice and outcome.

Results 127 patients were evaluated (aged 27 days to 18 years); 64 males and 63 females. The most frecuent symptoms were tumor (72%), macula (26%) and others (pain, functional disorders). 17 patients (13.4%) presented with hemangiomas, 110 (86.6%) with vascular malformations (VMs). Hemangiomas prevailed in the head and neck (10/17), meanwhile low-flow VMs (47/58) and high-flow VMs prevailed on limbs (9/10). Most hemangiomas occurred before 1 month from birth (13/17), whereas VMs did not differ regarding clinical onset. Outcome: a stable or favorable status was observed on hemangiomas, only 4 patients need surgery. Most low-flow VMs (34/35 patients) were treated with sclerotherapy and/or surgery, with favorable evolution in 26 patients (76.4%), 5 stable (14.7%) and 3 progressive (8%). Regarding high-flow VMs, all cases evolved to be stable or favorable with the treatment given.

Conclusions VAs comprise a range of lesions, spread over the whole body, with diverse diagnostic and therapeutical choices. Most hemangiomas only need clinical control. VMs were the majority in our series, mostly low-flow. They occured from neonatal stage to adulthood, and required some kind of therapy owing to their expanding growth, lack of remission and probability of complications.

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