Chap 69 Vascular Anomalies Flashcards
What is the first order classification of vascular anomalies?
Vascular tumors
vascular malformations
What is the sub-classification of vascular tumours?
infantile hemangioma
hemangioendothelioma
angiosarcoma
Misc
What is the sub-classification of vascular malformations?
Slow-flow
capillary malformation CM
lymphatic malfomation LM
venous malformation VM
Fast flow
arterial malformation
Combined
What is the most common location for infantile hemangiomas?
head and neck
Describe what slow flow CM are and treatment.
Red macular lesions seen at birth and persist throughout life
Laser tx for cosmesis
Names three diseases associated with SF CM.
sturge weber
cutis marmorata telangiectatica congenita
Macrocephaly-CM
Describe what SF VM look like and treatment.
Bluish compressible swellings
Can be painful
Can be extensive and lead to leg length discrepancy
At risk for systemic coagulopathy after trauma
Tx OR can have significant blood loss
tourniquet
Names three diseases associated with SF VM.
Glomuvenous malformation
Cutaneomucosal venous malformation
Blue rubber bleb nevus syndrome
Describe what SF LM are and treatment.
Microcystic cmor combined Tx lenticular excision Dissect off skin, not malignant need not excise everything May need to remove associated viscera Post op, suction drainage
Name types of fast flow VM.
AVF
AVM
What are symptoms of AVF?
LE—edema, hypertrophy, trophic changes
UE—pain, digital ischemia, discoloration of the digits
What is an AVM?
Center call nidus has feeding vessels, micro and macro AVFS and ecstatic veins
Where are AVM most commonly found?
Intracranial, followed by limbs, trunk and viscera
How do you stage AVM?
I quiescence Cutaneous blush, warmth (av shuntung on Doppler) Stage II expansion Bruit, audible pulsation, expanding lesion Stage II destruction Pain ulceration, bleeding, infection Stage IV decompensation Cardiac failure
What are indications to treat AVM?
pain ulceration, functional impairement, soft tissue and bony destruction and bleeding.
CHF
What is treatment for AVM?
Embolization alone or in combo
Embo nidus then resection next few days
What are variation of combine VM?
fast or slow
any combo of C, L, V, A
What is klippel-trenaunay syndrome?
slow flow Capillary-lymphaticovenous malformation
Large and small CM extremities and buttock
Lymphedema and LM in LE
Limb hypertrophy present at birth
What are side effects of KTS?
Infections, PE, thrombophleb, GI, constipation, bladder outlet obstruction , hematuria
What is parks weber?
Fast flow capillary arteriovenous malformation CAVM or CLAV<
Usually LE and trunk
Cutaneous flushing wih underlying multiple micro AVFS
large, flat, pink stains on the skin, and because of their color are sometimes called “port-wine stains
What is most common tumour of infancy?
infantil hemangioma
What is infantile hemangioma?
benign tumor of the endothelium most common neoplasm of infancy gros rapidly in first year then growth plateaus then shrinkage bright color fades becomes less tense. last phase complete by 4 yo
What is most common site of infantile hemangioma?
liver
can cause hepatomeg, IVE compression
How to diagnose infantile hemangioma?
US or MRI
What is treatment of infantile hemangioma?
conservation topical steroid laser embolic only for CHF excision only if at risk for injury and blood loss
