Comments regarding ‘Surgical Treatment of Patients with Congenital Vascular Malformation-associated Aneurysms’

Abstract

Through the last two decades, there has been a significant progress on the understanding of the nature of various congenital vascular malformations (CVMs), and the confusion based on old name-based eponyms and classification is now sufficiently cleared. Further, contemporary concept on the CVMs and its management by a multidisciplinary approach are now fully established. However, current knowledge is not sufficient enough to correct many unfair prejudices with a proper answer, and questions such as the aneurysm of congenital origin as the result of a birth defect remain to be answered. Among the arteriovenous malformations (AVMs), aneurysm formation along the feeding artery and/or draining veins is not rare at all; it is a ‘well anticipated’ haemodynamic reaction/consequence to such ‘high flow’ lesions. Together with a tortuosity, saccular or fusiform dilatation of the vessels is a common complication along the natural course of the progress of such lesion, when left alone. Therefore, all the extratruncular AVM lesions should be considered as candidates for aggressive control ‘before’ they progress to cause such potentially limb-threatening condition (e.g., aneurysmal rupture).