VASCULAR MALFORMATIONS – HEMANGIOMA
Introduction
Vascular malformations usually develop from embryonic life. As a rule, most malformations increase progressively after birth causing either an aesthetic or a functional problem (pain, edema etc.). Vascular malformations are erythematous lesions and are formed due to the pathological development of vessels (capillaries, veins, arteries or lymphatic vessels) and can appear at any point of the body.
Hemangiomas essentially constitute benign tumors, which appear after birth and have the form of red nodules or plaques. Their size can vary and their diagnosis is made mainly on the basis of the clinical picture of the patient. Depending on the size and the point at which they have appeared, hemangiomas can be treated with conservative or surgical treatment or even with laser.
The timely early diagnosis of the disease
is very important
for the good outcome of the condition in both stages of the disease.
Types of malformations
The malformations are divided into four categories:
The capillary malformations, which constitute the smallest vessels in the human body and appear more frequently on the face. These malformations rarely cause symptoms and the main indication for their treatment is the aesthetic problem they cause. Arteriovenous malformations which are created by abnormal communication between arteries and veins. These malformations are usually the most serious and cause intense symptoms.
The venous malformations δημιουργούνται μεταξύ φλεβών όπου αναπτύσσονται σε διάφορα σημεία του σώματος με ανεξέλεγκτο τρόπο. Ανάλογα με το σημείο που αναπτύσσονται, τα συμπτώματα μπορούν να ποικίλουν. Μια ιδιαίτερα εκτεταμένη μορφή φλεβικής δυσπλασίας αποτελεί το σύνδρομο Klippel Trenaunay.
The venous malformations usually develop in the lower limbs causing extensive edema (swelling) and cystic abnormalities.
Diagnosis of malformations
The diagnosis is made with the clinical picture in combination with imaging methods such as triplex, magnetic angiography and CT angiography.
Ποιες είναι οι επεμβατικές μέθοδοι χειρουργικής θεραπείας;
Treatment of Vascular malformations
Η therapy of malformations is demanding and requires particularly careful planning. It is important for the patient to know, that malformations require as a rule (depending on their extent and complexity) multiple interventions until the complete restoration of the problem is achieved.
Malformations at the level of capillaries that appear mainly on the face are treated with laser.
The arteriovenous malformations πρέπει να αντιμετωπίζονται ελάχιστα επεμβατικά αρχικά με εμβολισμό των αρτηριακών κλάδων και σε δεύτερο χρόνο, εάν κριθεί απαραίτητο, των φλεβικών κλάδων.
The φλεβο-φλεβικές δυσπλασίες are treated with direct embolization of these with the use of special embolic fluids (ethanol, atossisclerol). Due to the high probability of recurrence or the need for administration of large quantities of these fluids, a more specialized method particularly for extensive malformations in the body or on the face is electrophoresis with the simultaneous administration of the drug bleomycin. The mechanism of operation of this technique is the opening of the membranes of the cells through electrophoresis and at the same time the introduction of the drug inside the cells. This process increases by approximately 100 times the effect of the drug, which destroys the cells of the wall of the veins and the malformation gradually regresses. This same technique is used with the same great success also in malformations of the lymphatic vessels.
