Venous malformations: Clinical course and management of vascular birthmark clinic cases

• Published in: Australasian journal of dermatology Vol. 54; no. 1; pp. 22 - 30
• Main Authors: McRae, Michelle Y, Adams, Susan, Pereira, John, Parsi, Kurosh, Wargon, Orli
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.02.2013
• Subjects: Adolescent; Child; Child, Preschool; Female; Humans; Infant; Male; paediatric; Retrospective Studies; Treatment Outcome; vascular malformation; Vascular Malformations - diagnosis; Vascular Malformations - etiology; Vascular Malformations - therapy; venous malformation
• ISSN: 0004-8380; 1440-0960
• DOI: 10.1111/j.1440-0960.2012.00959.x

Background/Objectives Venous malformations (VM) are an uncommon vascular malformation with an estimated incidence of 1–2 per 10 000 births. The aim was to define the clinical characteristics and management of children with VM and develop a database for future research. Methods A retrospective chart review of all children presenting to the Vascular Birth Mark clinic with VM from 2000 to 2011. Results In total 128 patients were included, of whom 59.4% were female, 78.1% were Caucasian and 56.3% resided in a metropolitan area. Most lesions were noted at birth (64.1%) with an average age when VM was first noticed of 17.1 months. The average age of definitive diagnosis was 65.9 months. Locations most frequently involved were the lower limb (41.4%), face (21.1%), trunk (17.2%) and upper limb (15.6%). The most commonly associated conditions were capillary malformation (28.9%) and lymphatic malformation (28.1%). Magnetic resonance imaging was used in the majority of patients (86.7%) to assess tissue distribution of the lesions. Skin and subcutaneous tissue (61.3%), muscle (49.5%) and joints (11.7%) were most commonly involved. Complications of VM resulted in morbidity in 68.8% of cases, most commonly pain (52.3%), thrombophlebitis (17.2%), bleeding (13.3%) and limb length discrepancy (13.3%). Intervention was employed in 68.0%, most often with sclerotherapy (61.8%), compression garments (43.0%), and endovascular laser (17.2%) and surgical management (13.3%). Conclusions Given the frequent association of VM with other vascular lesions, considerable morbidity, and specialised treatment, a multidisciplinary approach to their management in childhood is important and should include dermatology, diagnostic and interventional radiology, haematology, paediatric surgery, physiotherapy and social services.