Abstract
The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety and systematizing treatment, employing evidence‐based medicine techniques and aimed at improvement of the outcomes. Clinical questions (CQ) were decided based on the important clinical issues. For document retrieval, key words for published work searches were set for each CQ, and work published from 1980 to the end of September 2014 was searched in PubMed, Cochrane Library and Japana Centra Revuo Medicina databases. The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System technique. A total of 33 CQ were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence‐based guidelines for the management of vascular anomalies.
Highlights
The etiology of vascular anomalies on the body surface and in soft tissue are mostly unclear and no fundamental treatment methods have been established
Comments: As a result of primary screening, 92, three and 27 papers were extracted from PubMed, Japana Centra Revuo Medicina (JCRM) and Cochrane Library, respectively, and, as a result of secondary screening, 37 and three papers were extracted from PubMed and JCRM, respectively
There has been no report in which time to begin treatment for arteriovenous malformation (AVM) in itself was the end-point, and only some reports described the view on the time to begin treatment in the discussion
Summary
The etiology of vascular anomalies on the body surface and in soft tissue are mostly unclear and no fundamental treatment methods have been established. The organization responsible for preparation was the Health, Labor and Welfare Sciences Research Grants (Research on Measures for Intractable Diseases), Research Committee for “Intractable Vascular Anomalies”, and the main committee members were selected from academic societies of plastic surgery and radiology mainly treating hemangiomas and vascular malformations: the Japanese Society of Plastic and Reconstructive Surgery and Japanese Society of Interventional Radiology, and the guidelines were prepared by them. The organization responsible for preparation was the Health, Labor and Welfare Sciences Research Grants (Research on Policy Planning and Evaluation for Rare and Intractable Diseases), Research Committee for Intractable Vascular Anomalies, and the differences from the previous guidelines are setting the objective of summarizing opinions from related academic societies by inviting many committee members from dermatologists, pediatric surgeons, pediatricians, radiologists (diagnostic radiology), and basic researchers including the pathology, molecular biology and epidemiology fields, in addition to plastic surgeons and radiologists (interventional radiology). Because the guidelines were prepared following the reformed Minds Handbook for Clinical Practice Guideline Development 20144 and Minds Manual for Clinical Practice Guideline Development Ver. 1.0–2.0,5,6 it was fully revised
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