title: Surgical treatment of patients with congenital vascular malformation-associated aneurysms.
abstract: OBJECTIVE
  Aneurysms associated with congenital vascular malformation (CVM) comprise critical complication. We review our experience with extracranial CVM-associated aneurysms and attempt to clarify their clinical features.
  
  
  METHODS
  The prevalence, site, size and morphology of the accompanying aneurysms of 48 consecutive CVM patients, who were managed at our hospital from 1999 to 2008, were evaluated. After diagnosis or treatment, the patients were followed up, and the recurrence of aneurysms and patient survival were assessed.
  
  
  RESULTS
  CVM-associated aneurysms were found in 14 patients (29%). CVMs were classified according to the Hamburg classification. The patients were classified into groups as follows: four (31%), in the 'predominantly arteriovenous (AV) shunting defect type'; eight (47%), 'combined vascular defects + predominantly AV shunting defects type'; and two (11%), 'combined vascular defects type'. All aneurysms except one situated at the CVM were saccular, whereas nine were fusiform aneurysms; all the ruptured aneurysms and seven out of the nine enlarging aneurysms were saccular. Surgical treatment was performed 8 times in six patients. During the postoperative follow-up period, recurrence and an aneurysm rupture were encountered in one patient each.
  
  
  CONCLUSIONS
  Aneurysm is not a rare complication of CVM. It is important to treat CVM before the emergency presents. In addition to the treatment for malformation, regular screening for and proper management of the aneurysms in CVM patients are indispensable.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Graduate school of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Suzuki
authors.forename: T
authors.initials: T
authors.lastname: Miyata
authors.forename: K
authors.initials: K
authors.lastname: Hoshina
authors.forename: H
authors.initials: H
authors.lastname: Okamoto
authors.forename: H
authors.initials: H
authors.lastname: Kimura
authors.forename: K
authors.initials: K
authors.lastname: Shigematsu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D054079:Vascular Malformations / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult