Cliniques universitaires Saint-Luc

Cliniques universitaires Saint-Luc

Centre for vascular anomalies

Vascular malformations

Capillary malformation

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
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

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
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

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
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
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

Combined vascular malformations can be subclassified into high-flow lesions with arteriovenous malformation

Figure 9: Arteriovenous malformation
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
16-year-old girl with CLV malformation
of her left lower extremity and soft tissue overgrowth
(Copyright 1999 L.M. Boon)