Chap 69 Vascular Anomalies

Question 1

What is the first order classification of vascular anomalies?

Answer 1

Vascular tumors

vascular malformations

Question 2

What is the sub-classification of vascular tumours?

Answer 2

infantile hemangioma
hemangioendothelioma
angiosarcoma
Misc

Question 3

What is the sub-classification of vascular malformations?

Answer 3

Slow-flow
capillary malformation CM
lymphatic malfomation LM
venous malformation VM

Fast flow
arterial malformation

Combined

Question 4

What is the most common location for infantile hemangiomas?

Answer 4

head and neck

Question 5

Describe what slow flow CM are and treatment.

Answer 5

Red macular lesions seen at birth and persist throughout life
Laser tx for cosmesis

Question 6

Names three diseases associated with SF CM.

Answer 6

sturge weber
cutis marmorata telangiectatica congenita
Macrocephaly-CM

Question 7

Describe what SF VM look like and treatment.

Answer 7

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

Question 8

Names three diseases associated with SF VM.

Answer 8

Glomuvenous malformation
Cutaneomucosal venous malformation
Blue rubber bleb nevus syndrome

Question 9

Describe what SF LM are and treatment.

Answer 9

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

Question 10

Name types of fast flow VM.

Answer 10

AVF

AVM

Question 11

What are symptoms of AVF?

Answer 11

LE—edema, hypertrophy, trophic changes

UE—pain, digital ischemia, discoloration of the digits

Question 12

What is an AVM?

Answer 12

Center call nidus has feeding vessels, micro and macro AVFS and ecstatic veins

Question 13

Where are AVM most commonly found?

Answer 13

Intracranial, followed by limbs, trunk and viscera

Question 14

How do you stage AVM?

Answer 14

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

Question 15

What are indications to treat AVM?

Answer 15

pain ulceration, functional impairement, soft tissue and bony destruction and bleeding.
CHF

Question 16

What is treatment for AVM?

Answer 16

Embolization alone or in combo

Embo nidus then resection next few days

Question 17

What are variation of combine VM?

Answer 17

fast or slow

any combo of C, L, V, A

Question 18

What is klippel-trenaunay syndrome?

Answer 18

slow flow Capillary-lymphaticovenous malformation
Large and small CM extremities and buttock
Lymphedema and LM in LE
Limb hypertrophy present at birth

Question 19

What are side effects of KTS?

Answer 19

Infections, PE, thrombophleb, GI, constipation, bladder outlet obstruction , hematuria

Question 20

What is parks weber?

Answer 20

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

Question 21

What is most common tumour of infancy?

Answer 21

infantil hemangioma

Question 22

What is infantile hemangioma?

Answer 22

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

Question 23

What is most common site of infantile hemangioma?

Answer 23

liver

can cause hepatomeg, IVE compression

Question 24

How to diagnose infantile hemangioma?

Answer 24

US or MRI

Question 25

What is treatment of infantile hemangioma?

Answer 25

conservation
topical steroid
laser
embolic only for CHF
excision only if at risk for injury and blood loss