URL: http://www.saintluc.be/en/services/vascular-anomalies/vascular-malformations.php
Capillary malformation (portwine stain) is diagnosed at birth as a red stain that grows commensurably with the child.
Facial portwine stain can, in some instances, be responsible for epilepsy and glaucoma (Sturge-Weber syndrome).
Pulse dye laser is currently the best treatment in order to reduce the red color. It can be done under local (Emla cream) or general anesthesia (one day clinic).
| Figure 5: capillary malformation | |
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| 10-month-old girl with extensive CM of upper extremity. |
After 3 sessions of VBeam Perfecta pulsed dye laser under general anesthesia. |
| (Copyright © 1999 L.M. Boon) | |
Lymphatic malformation can be micro- or macrocystic. Its major complication is recurrent infections that necessitate systemic antibiotherapy.
The most common therapeutic approach is surgical resection. Sclerotherapy can be done in some cases of macrocystic lymphatic malformation or in the presence of oozing from small cutaneous lymphatic vesicules.
| Figure 6: Lymphatic malformation |
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| LM membre inf drt, genital et abdo picybanyl au niveau inguinal, greffe de peau orteil et chg abdo 4.5 ans |
| (Copyright © 1999 L.M. Boon) |
Venous malformation is a very common vascular dysmorphogenesis. Depending on its size and location, it can cause pain, anatomic distortion or even threaten life. The treatment of choice is often the combination of sclerotherapy and surgical resection.
| Figure 7: Venous malformation | |
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| 30-year-old man with an extensive cervicofacial venous malformation involving not only the skin but also the subcutaneous tissue and muscle of the cheek and chin. |
2 years follow-up after 2 sclerotherapies with direct ethanol injections. |
| (Copyright © 1999 L.M. Boon) | |
| Figure 8: Venous malformation | |
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| 4-year-old girl with well-circumscribed venous malformation located under the pectoralis muscle. | Result 2 years after 2 sessions of sclerotherapy followed by surgical resection by axillary incision. |
| (Copyright © 1999 L.M. Boon) | |
Combined vascular malformations can be subclassified into high-flow lesions with arteriovenous malformation
| Figure 9: Arteriovenous malformation | |
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| 49-year-old man with stage III arteriovenous malformation of the ankle causing pain and ulceration. | 5 month after total surgical resection and closure with free flap latissimus dorsi muscle and skin graft. |
| (Copyright © 1999 L.M. Boon) | |
and low-flow malformation with Klippel-Trenaunay syndrome that is characterized by a capillary lymphatico-venous malformation (CLV) with soft tissue (and sometimes bone) overgrowth (Fig 10).
| Figure 10: Capillary-lymphatico-venous malformation |
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| 16-year-old girl with CLV malformation of her left lower extremity and soft tissue overgrowth |
| (Copyright © 1999 L.M. Boon) |