Surgery in patients with vascular malformations of the head and neck: value of coagulation disorders.
OBJECTIVE
The surgical treatment of congenital vascular malformations always bears the risk of severe bleeding. The aim of this study was to investigate the prevalence of haemostatic abnormalities in patients with congenital vascular malformations of the head and neck which could additionally complicate the complex surgery of vascular malformations.


METHODS
Thirteen patients with congenital vascular malformations of the head and neck, who underwent scheduled surgery, were reviewed regarding their haemostatic tests, including prothrombin time, activated partial thromboplastin time, fibrinogen level, platelet count, platelet function analyzer-epinephrine (PFA-Epi) and -adenosine diphosphate (ADP) (PFA-100), von Willebrand factor (vWF) and D-dimers.


RESULTS
In six of 13 patients an impaired primary haemostasis was detected by prolonged PFA-Epi and one of these patients also had a slightly prolonged PFA-ADP. Additionally, two of the patients showed mild coagulation factor deficiency. One patient had a mild vWF deficiency that was not detected by PFA-100.


CONCLUSIONS
Prior to surgery of congenital vascular malformations of the head and neck, a detailed coagulation analysis is needed in order to identify those patients at increased risk of bleeding. This proceeding is supported by the fact that a relevant portion of the patients with congenital vascular malformations of the head and neck show an impaired primary haemostasis.
Wiegand
S
S
Department of Otolaryngology, Head and Neck Surgery, Philipps-University of Marburg, Deutschhausstr. 3, 35037 Marburg, Germany. swiegand@med.uni-marburg.de
Eivazi
B
B
Karger
R
R
Al Kadah
B
B
Sesterhenn
A M
AM
Werner
J A
JA
D000293:Adolescent; D000328:Adult; D001778:Blood Coagulation Disorders / Q000175:diagnosis / Q000453:epidemiology*; D001780:Blood Coagulation Tests; D002648:Child; D005260:Female; D006257:Head / Q000098:blood supply; D006391:Hemangioma / Q000453:epidemiology / Q000601:surgery; D006470:Hemorrhage / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000098:blood supply; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D054079:Vascular Malformations / Q000453:epidemiology* / Q000601:surgery*; D019043:Vascular Neoplasms / Q000453:epidemiology / Q000601:surgery; D055815:Young Adult