- See: venous malformations
- high flow lesion
- may start small in childhood and be triggered to enlarge after trauma
- spontaneous bleeding may occur
- associated conditions:
- Klippel-Trénaunay syndrome: capillary, lymphatic, and venous malforma-tions with skeletal overgrowth;
- Parkes Weber syndrome: capillary, lymphatic, and venous malforma-tions with arteriovenous fistuli;
- Proteus syndrome: capillary and venous malformations, macro-dactyly, hemihypertrophy, lipomas, pigmented nevi, and scoliosis;
- Maffucci’s syndrome: lymphatic and venous malformations and multiple enchondromas;
- Clinical Findings:
- possible thrill
- dilated surrounding veins
- ischemic ulcers distal to the lesion;
- doppler: continuous murmur
- MRI: high versus low flow
- constrast arteriography
- resection may be dangerous
- consider embolization therapy
- ligation of feeding vessels of no help
- high-flow arteriovenous malformations are difficult to treat, & staged partial excisions are mostly palliative;
- proximal ligation only increases collateralization, and embolization carries a high risk of digital ischemia;
- YAG laser, used in direct contact with tissue for incision & thermal coagulation, has allowed subtotal excision of complicated hemangiomas of the hand previously thought to be untreatable;
- laser will not stop bleeding from blood vessels w/ lumen diameters greater than 1 mm
Distinguishing Soft-Tissue Hemangiomas From Vascular Malformations Using Technetium-Labeled Red Blood Cell Scintigraphy.
Arteriovenous malformations of the extremities: MR imaging.
Hemangiomas, vascular malformations, and lymphovenous malformations: classification and methods of treatment.
Vascular abnormalities of the extremities: clinical findings and management.
Major vascular malformations of the upper extremity: long-term observation.