Therapeutic tactics and late results in predominant truncal congenital malformation.
BACKGROUND
Congenital vascular malformations are rare vascular lesions of unknown etiology, non-degenerative or of inflammatory nature, which begin during embryological development; they are characterized by anomalies of the vascular system, apparently due to hemodynamic and metabolic disturbances.


METHODS
Our diagnostic and therapeutic management in addition to the late results in 60, mainly truncal cases, out of 265 congenital vascular malformations, are analyzed in the present study. In a 20-year period 25,000 vascular examinations were carried out, among which 265 (1.06%) congenital vascular malformations (CVMs) were discovered, that is 77% (205/265) extra-truncal venous angiomata and 22.7% (60/265) truncal diffuse or localized types. The distribution of the above types was: 22 (36.6%) arteriovenous, 30 (50%) venous and 8 (13.4%) lymphatic.


RESULTS
Surgery was carried out in 48.3% (29/60) of the truncal types of which 37.9% of the cases, on average, recurred 8 years later. Of the 22 arteriovenous malformations 20 patients were operated on (90%), of whom 35% (7/20) had a recurrence; of the 30 venous defects 30% (9/30) were operated on and 44.5% (4/9) of these had a recurrence. The recurrence rate rose to 50% (5/10) in cases of operative therapy of arteriovenous defects and to 20% (2/10) with combined surgical and non surgical methods. The recurrence incidence of venous defects with surgical treatment and sclerotherapy was 54.1% (6/11).


CONCLUSIONS
Timely diagnosis, microsurgical techniques and highly specialized surgical and interventional experience are expected to improve these results significantly.
Dimakakos
P B
PB
Department of Vascular Surgery, University of Athens, Aretaeion Hospital, Greece.
Arapoglou
V
V
Katsenis
K
K
Kotsis
T
T
Mourikis
D
D
D000015:Abnormalities, Multiple; D000293:Adolescent; D000328:Adult; D001165:Arteriovenous Malformations / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000151:congenital* / Q000175:diagnosis / Q000628:therapy; D008208:Lymphatic System / Q000002:abnormalities*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures