Incidence and Management of Congenital Vascular Malformations – An Institutional Experience

Abstract

Abstract Introduction: Congenital vascular malformations (CVMs) are malformed vessels developed due to arrested development at various stages of embryogenesis. Arterial venous malformations (VMs) are complex primitive networks of arterial and venous channels (a nidus) that bypass the normal capillary bed. The management of CVM remains challenging because of their unpredictable behavior, high recurrence rate, and need for multidisciplinary management. In this study, we report on the incidence and management of CVM in our institution and its outcome. Materials and Methods: This is a retrospective analysis of CVM patients who were admitted in our institute from January 2010 to June 2023. In this study, 321 patients who presented with CVM are considered. Once a CVM was diagnosed, all underwent angiographic confirmation as a roadmap for treatment. Embolization, sclerotherapy, and surgical procedures were instituted by the multidisciplinary team with periodic follow-up. Results: Out of the 321 patients analyzed, VM predominates with 202 cases (62.9%), out of which 105 (51.9%) were treated with sclerotherapy, 66 (28.21%) were treated with excision, 40 (19.8%) were managed conservatively. Among 108 arteriovenous malformation (33.64%), 33 (30.55%) patients were treated with excision followed by repair and flap cover/split skin graft, 32 (29.62%) were treated with glue Embolization, 7 (6.48%) were treated with embolization followed by excision, one patient presented with life-threatening bleeding was treated by emergency ECA ligation followed by elective excision, 21 (19.44%) were managed conservatively and 13 (12.03%) patients were not willing for surgery. Seven (2.1%) lymphovenous malformation and 4 (1.24%) lymphatic malformations patients were also treated. Conclusion: Diagnosis and management of CVMs by a multidisciplinary approach that integrates surgical therapy with embolization and sclerotherapy appear to improve the results and management.