Advances in the Medical Management of Vascular Anomalies

Abstract

Vascular anomalies comprise a spectrum of diseases that are broadly classified as tumors and malformations. Diagnosis is often challenging, given a wide range of clinical presentations with overlapping signs and symptoms. Accurate diagnosis is critical to determine prognosis and to generate a management plan, which frequently involves multiple subspecialists during different phases of treatment. An updated classification system provides structure and clear, consistent terminology, allowing for improved diagnosis, provider communication, and collaboration. Historically, treatment of vascular anomalies was primarily surgical and medical therapies were limited or ineffective. Recent discoveries of pharmacologic agents effective in treating vascular anomalies have broadened our medical therapeutic options, limiting the need for unnecessary or high-risk procedures and improving patients' quality of life.

Keywords: interventional radiology; propranolol; sirolimus; timolol; vascular anomaly; vascular malformation.

Fig. 1

MRI of a patient with capillary lymphatico-venous malformation with significant disease resulting in right hip dislocation prior to the start of sirolimus ( left ). Hip dislocation resolved and bulk of disease substantially improved at 6 months of sirolimus treatment ( right ).

Fig. 2

Chest X-ray of a patient with generalized lymphatic anomaly with a right-sided pleural effusion before the start of sirolimus treatment ( left ). Pleural effusion exhibited near-complete resolution at 3 months of sirolimus therapy ( right ).