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1.
Tech Vasc Interv Radiol ; 22(4): 100628, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864528

RESUMO

Ongoing discovery regarding the origin and treatment of vascular anomalies requires standardized nomenclature which itself must undergo iterative updating. This article introduces the 2018 International Society for the Study of Vascular Anomalies (ISSVA) classification, emphasizing the biologic basis of vascular anomalies, summarizing the key features of commonly encountered entities, and serving as a foundation for subsequent articles presented herein. Vascular tumors are discussed to highlight their distinction from vascular malformations which will receive greater attention with respect to management and technical considerations within the issue.


Assuntos
Neoplasias de Tecido Vascular/classificação , Neoplasias de Tecido Vascular/diagnóstico por imagem , Radiologistas , Terminologia como Assunto , Malformações Vasculares/classificação , Malformações Vasculares/diagnóstico por imagem , Humanos , Neoplasias de Tecido Vascular/terapia , Valor Preditivo dos Testes , Prognóstico , Malformações Vasculares/terapia
3.
Radiología (Madr., Ed. impr.) ; 61(2): 124-133, mar.-abr. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185122

RESUMO

Las malformaciones vasculares y los tumores, también conocidos como "anomalías vasculares", comprenden una extensa variedad de lesiones en diferentes partes del cuerpo. El origen y la histopatología de estas lesiones no es del todo conocido, por ello este campo se ha visto ensombrecido por el uso de una nomenclatura poco clara. Conocer su clasificación, así como las características clínicas y de imagen es de vital importancia para el manejo de estos pacientes. El objetivo de esta serie de dos artículos es revisar la clasificación actual de las anomalías vasculares, describir el papel que desempeñan las pruebas de imagen en su diagnóstico, resumir sus características histopatológicas, clínicas y de imagen y debatir las posibles opciones terapéuticas. El primer artículo de esta serie versó sobre las lesiones de alto flujo. En este segundo artículo nos centraremos en las de bajo flujo, incluidos los síndromes complejos que asocian malformaciones de bajo flujo


Vascular malformations and tumors, also known as "vascular anomalies", comprise an extensive variety of lesions involving all parts of the body. Due to a lack of a complete understanding of the origin and histopathology of such lesions, this field has been traditionally obscured by the use of an unclear nomenclature. Knowledge of the classification and clinical and imaging characteristics of this group of lesions is paramount when managing these patients. The objective of this series of two articles is to review the current classification of vascular anomalies, to describe the role of imaging in their diagnosis, to summarize their distinctive histopathologic, clinical and imaging features, and to discuss the treatment options. High-flow lesions were discussed in the first article of this series. In this second article, we will focus on low-flow lesions, including complex syndromes with associated low-flow malformations


Assuntos
Humanos , Malformações Vasculares/diagnóstico por imagem , Neoplasias de Tecidos Moles/diagnóstico por imagem , Hemangioma/diagnóstico por imagem , Espectroscopia de Ressonância Magnética/métodos , Angiografia/métodos , Malformações Vasculares/classificação
4.
Radiología (Madr., Ed. impr.) ; 61(1): 4-15, ene.-feb. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-185072

RESUMO

Las malformaciones vasculares y los tumores, también conocidos como «anomalías vasculares», comprenden una extensa variedad de lesiones en diferentes partes del cuerpo. Conocer su clasificación y características en las imágenes es de vital importancia. Si bien los hemangiomas son tumores vasculares benignos caracterizados por proliferación celular e hiperplasia, las malformaciones vasculares no son verdaderos tumores y muestran, típicamente, una renovación endotelial normal. Las malformaciones vasculares se clasifican, según el vaso predominante, en arteriales, capilares, venosas, linfáticas o mixtas. La ecografía y la resonancia magnética son las técnicas de imagen que se usan en el diagnóstico y la clasificación de las anomalías vasculares. En esta serie de dos artículos revisaremos la clasificación de las anomalías vasculares, describiremos el papel que desempeñan las pruebas de imagen, resumiremos sus características histopatogénicas, clínicas y de imagen, y comentaremos las posibles opciones terapéuticas. En este primer artículo hablamos de las lesiones de alto flujo, y en el segundo lo haremos de las de bajo flujo. También trataremos los síndromes complejos asociados tanto a los tumores vasculares como a las malformaciones


Vascular malformations and tumors, also known as "vascular anomalies", comprise an extensive variety of lesions involving all parts of the body. Knowledge of their classification and imaging characteristics is paramount. Whereas hemangiomas are benign vascular tumors, characterized by cellular proliferation and hyperplasia; vascular malformations are not real tumors and characteristically exhibit normal endothelial turnover. Vascular malformations are classified according to the predominant vascular channel as arterial, capillary, venous, lymphatic, or mixed. Ultrasound and MRI are the main imaging modalities used in the diagnosis and classification of the vascular anomalies. In this series of two articles we review the classification of vascular anomalies, describe the role of imaging, summarize their distinctive histopathogenic, clinical and imaging features, and discuss the treatment options. On the first article we discuss the high-flow lesions, whereas the slow-flow lesions will be reviewed on the second. Complex syndromes with associated vascular tumors and malformations will be also presented


Assuntos
Humanos , Neoplasias de Tecidos Moles/diagnóstico por imagem , Malformações Vasculares/classificação , Diagnóstico por Imagem/métodos , Neoplasias Vasculares/diagnóstico por imagem , Hemangioma/diagnóstico por imagem , Neoplasias de Tecidos Moles/complicações , Malformações Vasculares/diagnóstico por imagem , Diagnóstico Diferencial
5.
Cardiovasc Pathol ; 39: 38-50, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30623879

RESUMO

The traditional classification of congenital aortic arch abnormalities was described by James Stewart and colleagues in 1964. Since that time, advances in diagnostic imaging technology have led to better delineation of the vasculature anatomy and the identification of previously unrecognized and unclassified anomalies. In this manuscript, we review the existing literature and propose a series of modifications to the original Stewart classification of congenital aortic arch abnormalities to incorporate this new knowledge. In brief, we propose the following modifications: (1) In Group I, we further divide subgroup B into left arch atretic and right arch atretic; (2) In Group II, we add three more subgroups, including aberrant right innominate artery, "isolated" right innominate artery (RIA), "isolated" right carotid artery with aberrant right subclavian artery; (3) In Groups I, II, and III, we add a subgroup of absence of both ductus arteriosus; and (4) In Group IV, we add three subgroups, including circumflex retro-esophageal aorta arch, persistent V aortic arch, and anomalous origin of pulmonary artery from ascending aorta.


Assuntos
Aorta Torácica/anormalidades , Cardiopatias Congênitas/classificação , Terminologia como Assunto , Malformações Vasculares/classificação , Aorta Torácica/diagnóstico por imagem , Tomada de Decisão Clínica , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/terapia , Humanos , Valor Preditivo dos Testes , Prognóstico , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/terapia
6.
Medicine (Baltimore) ; 98(2): e14125, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30633228

RESUMO

An in-utero re-classification of umbilical-portal-systemic venous shunt (UPSVS) has recently been proposed. We retrospectively reviewed the sonograms of a large cohort of fetuses, identified and analyzed UPSVS cases, and presented the prenatal sonographic characteristics, birth outcomes, and follow-up results following the new classification system.Sonograms and clinical data of all participants who visited our departments from April 2016 to July 2018 were retrospectively reviewed. Identified cases of UPSVS were analyzed according to the new classification: Type I: umbilical-systemic shunt (USS); Type II: ductus venosus-systemic shunt (DVSS); Type IIIa: intrahepatic portal-systemic shunt (IHPSS) and Type IIIb: extrahepatic portal-systemic shunt (EHPSS). Postnatal follow-ups ranged from 3 months to 1 year.A total of 10 UPSVS cases were identified in 61,082 fetuses: 4 with Type I, 3 with Type II and 3 with Type IIIa. All 4 cases of USS had complete agenesis of the portal venous system, and had the umbilical vein drained into the inferior vena cava. Two USS cases also had trisomy 21. Pregnancy was terminated in all cases with a Type I shunt. Two fetuses with DVSS had normal portal venous system and were born full term. The pregnancy of 1 DVSS case was terminated due to the detection of trisomy 21. Three cases were IHPSS with full-term birth. One had chromosomal abnormality and 1 had surgery to repair the shunt 12-days post birth. In the 2 cases that did not receive repair surgery, sonographic examination revealed the portal-hepatic venous shunt was not closed at the 6-month follow-up period. However, the 1 case that had repair surgery appeared healthy at the 3-month follow-up period.UPSVS is extremely rare. Type I shunts have the poorest prognosis, and the presence of the intrahepatic portal venous system is key to live birth in UPSVS regardless of types. Chromosomal abnormalities and other organ anomalies can occur in any types of UPSVS. Therefore, karyotyping and examination of other organs should be performed once UPSVS is detected.


Assuntos
Veia Porta/anormalidades , Ultrassonografia Pré-Natal , Malformações Vasculares/classificação , Malformações Vasculares/diagnóstico por imagem , Progressão da Doença , Feminino , Seguimentos , Humanos , Recém-Nascido , Masculino , Veia Porta/diagnóstico por imagem , Gravidez , Prognóstico , Estudos Retrospectivos , Malformações Vasculares/terapia
7.
J Hand Surg Eur Vol ; 44(3): 233-241, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30380989

RESUMO

Vascular anomalies are common in the upper extremities, but there continues to be a relative paucity of information about them in publications dealing with surgery in the hands and upper limbs. The wide spectrum of pathology and an inconsistent use of terminology make vascular anomalies susceptible to incorrect diagnosis and as a result, to misdirected management. This article aims to provide an update on vascular anomalies relevant to the upper limbs, focusing on significant advances in pathogenesis and genetics, classification systems, diagnosis and treatment.


Assuntos
Neoplasias de Tecido Vascular/diagnóstico , Neoplasias de Tecido Vascular/terapia , Extremidade Superior/irrigação sanguínea , Malformações Vasculares/diagnóstico , Malformações Vasculares/terapia , Classe I de Fosfatidilinositol 3-Quinases/genética , Humanos , Anormalidades Musculoesqueléticas/genética , Mutação , Malformações Vasculares/classificação
8.
Radiologia ; 61(2): 124-133, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30292466

RESUMO

Vascular malformations and tumors, also known as "vascular anomalies", comprise an extensive variety of lesions involving all parts of the body. Due to a lack of a complete understanding of the origin and histopathology of such lesions, this field has been traditionally obscured by the use of an unclear nomenclature. Knowledge of the classification and clinical and imaging characteristics of this group of lesions is paramount when managing these patients. The objective of this series of two articles is to review the current classification of vascular anomalies, to describe the role of imaging in their diagnosis, to summarize their distinctive histopathologic, clinical and imaging features, and to discuss the treatment options. High-flow lesions were discussed in the first article of this series. In this second article, we will focus on low-flow lesions, including complex syndromes with associated low-flow malformations.


Assuntos
Sistema Linfático/anormalidades , Neoplasias de Tecidos Moles/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Tecido Adiposo/irrigação sanguínea , Tecido Adiposo/diagnóstico por imagem , Humanos , Síndrome de Klippel-Trenaunay-Weber/diagnóstico por imagem , Sistema Linfático/diagnóstico por imagem , Nevo Azul/diagnóstico por imagem , Mancha Vinho do Porto/diagnóstico por imagem , Mancha Vinho do Porto/terapia , Síndrome de Proteu/patologia , Fluxo Sanguíneo Regional , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias de Tecidos Moles/classificação , Neoplasias de Tecidos Moles/terapia , Síndrome de Sturge-Weber/diagnóstico por imagem , Malformações Vasculares/classificação , Malformações Vasculares/terapia , Veias/anormalidades
9.
Radiologia ; 61(1): 4-15, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30292467

RESUMO

Vascular malformations and tumors, also known as "vascular anomalies", comprise an extensive variety of lesions involving all parts of the body. Knowledge of their classification and imaging characteristics is paramount. Whereas hemangiomas are benign vascular tumors, characterized by cellular proliferation and hyperplasia; vascular malformations are not real tumors and characteristically exhibit normal endothelial turnover. Vascular malformations are classified according to the predominant vascular channel as arterial, capillary, venous, lymphatic, or mixed. Ultrasound and MRI are the main imaging modalities used in the diagnosis and classification of the vascular anomalies. In this series of two articles we review the classification of vascular anomalies, describe the role of imaging, summarize their distinctive histopathogenic, clinical and imaging features, and discuss the treatment options. On the first article we discuss the high-flow lesions, whereas the slow-flow lesions will be reviewed on the second. Complex syndromes with associated vascular tumors and malformations will be also presented.


Assuntos
Neoplasias de Tecidos Moles/classificação , Neoplasias de Tecidos Moles/diagnóstico por imagem , Malformações Vasculares/classificação , Malformações Vasculares/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Fluxo Sanguíneo Regional , Neoplasias de Tecidos Moles/fisiopatologia , Neoplasias de Tecidos Moles/terapia , Ultrassonografia Doppler , Malformações Vasculares/fisiopatologia , Malformações Vasculares/terapia
10.
Curr Probl Diagn Radiol ; 48(1): 10-16, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29129347

RESUMO

AIM: There is controversy regarding the diagnosis and classification of vascular anomalies (VA). As torso and extremities are the second most common body part for presentation of VAs, musculoskeletal (MSK) radiologists play a central role in VA classification. The purpose of this study was to evaluate the awareness and clinical use of the International Society for the Study of Vascular Anomalies (ISSVA) classification by MSK radiologists. MATERIALS AND METHODS: A Web-based survey was designed and electronically sent to Society of Skeletal Radiology (SSR) members, with 3 questions on demographics and 7 questions on ISSVA classification use and knowledge. The Z-test for binomial proportions is used to assess for statistical significance between subgroups. RESULTS: The response rate was 12% (130 of 1091), comprised of 64% (83 of 130) academic and 36% (47 of 130) nonacademic MSK radiologists. VAs accounted for only a small (0%-5%) proportion of clinical practice in the majority 92% (119 of 130). Only 17% (22 of 130) of MSK radiologists used the ISSVA classification in practice. Of all respondents, 74% (94 of 127) considered hemangioma a type of vascular malformation (VM). There was no significant difference in the response characteristics between academic and nonacademic radiologists. A greater proportion of MSK radiologists with >5 years' experience provided responses that were discordant with the ISSVA classification compared with less experienced radiologists (0-5 years) in diagnosing hemangiomas in adult patients (P = 0.02), and using the presence of phleboliths to diagnose hemangiomas (P = 0.004). CONCLUSION: Our survey results indicate a lack of familiarity with the ISSVA classification by the MSK radiology community.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Radiologistas , Malformações Vasculares/classificação , Malformações Vasculares/diagnóstico por imagem , Humanos , Sociedades Médicas , Inquéritos e Questionários
11.
Bol. pediatr ; 59(247): 54-60, 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-183167

RESUMO

Las anomalías vasculares, a pesar de ser un motivo frecuente de consulta en la edad pediátrica, son un tipo de patología poco conocida en la práctica clínica. esto dificulta la realización de un diagnóstico correcto y, por lo tanto, impide aplicar el tratamiento preciso en cada caso. la nomenclatura ha sido sin duda el mayor obstáculo para el conocimiento de estas lesiones, ya que hasta hace pocos años se utilizaba una terminología puramente descriptiva y errónea, lo que puede dar lugar a errores muy importantes de conceptos. a lo largo de este capítulo abordaremos de manera actualizada los dos grandes grupos de anomalías vasculares: los tumores y las malformaciones. Nos centraremos en aquellos que consideramos más importantes, bien por su frecuencia o por la posibilidad de provocar complicaciones más o menos graves. describiremos las principales características clínicas de cada uno de ellas, las pruebas complementarias que se necesitan en cada caso para realizar un diagnóstico diferencial correcto y las distintas posibilidades terapéuticas con las que contamos actualmente


Despite the fact that vascular anomalies being a frequent cause for consultation in paediatric patients, little is known about this type of pathology in clinical practice. this means it is difficult to ensure a correct diagnosis and hence apply the precise treatment in each case. the nomenclature has undoubtedly been the biggest obstacle to our knowledge of these injuries. Until recently, purely descriptive and erroneous terminology was employed, which may give rise to very important conceptual errors. throughout this chapter, we shall approach two major groups of vascular anomalies, tumours and malformations, from a more current perspective. We shall focus on those we consider the most important, either because of their frequency or because they may lead to more or less serious complications. We shall describe the main clinical characteristics of each of these anomalies, the complementary tests needed in each case to make a correct differential diagnosis, and the different therapeutic possibilities that are currently available


Assuntos
Humanos , Criança , Malformações Vasculares/classificação , Neoplasias de Tecido Vascular/classificação , Malformações Vasculares/diagnóstico , Malformações Vasculares/terapia , Neoplasias de Tecido Vascular/diagnóstico , Neoplasias de Tecido Vascular/terapia
12.
J Vasc Interv Radiol ; 29(11): 1595-1600.e9, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30293730

RESUMO

Angiograms and cone-beam computed tomography scans of 36 consecutive prostate artery embolization patients (72 hemipelves) between October 2014 and February 2018 were reviewed. The hemipelves were classified according to the presence of dual central gland (CG) blood supply and the pattern of vascularization: Type 1 with a single CG blood supply (83.3%; n = 60); Type 2 with 2 independent CG arteries with overlapping territories (9.7%; n = 7); and Type 3 with 2 independent CG arteries with isolated territories (7%; n = 5). Up to 20% of pelvic sides may have more than 1 independent CG prostate artery that should be searched for during prostate artery embolization.


Assuntos
Artérias/anormalidades , Próstata/irrigação sanguínea , Malformações Vasculares/classificação , Idoso , Angiografia , Artérias/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Embolização Terapêutica , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Hiperplasia Prostática/diagnóstico por imagem , Hiperplasia Prostática/terapia , Estudos Retrospectivos , Malformações Vasculares/diagnóstico por imagem
13.
Ugeskr Laeger ; 180(36)2018 Sep 03.
Artigo em Dinamarquês | MEDLINE | ID: mdl-30187855

RESUMO

The classification of vascular anomalies has been revised, as physicians and researchers have recognised an increasing number of vascular anomalies. The International Society for the Study of Vascular Anomalies presents a classification distinguishing between tumours and malformations. Over the years, an inaccurate application of the term haemangioma has been used, which has led to confusion among physicians. By using the classification and combining it with a thorough history and objective examination a classification of the most common vascular anomalies should be possible.


Assuntos
Neoplasias de Tecido Vascular/classificação , Malformações Vasculares/classificação , Hemangioma/classificação , Hemangioma/diagnóstico por imagem , Hemangioma/patologia , Humanos , Neoplasias de Tecido Vascular/patologia , Mancha Vinho do Porto/classificação , Mancha Vinho do Porto/patologia , Malformações Vasculares/patologia
14.
J Pediatr ; 203: 294-300.e2, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30244993

RESUMO

OBJECTIVE: To define the types of hepatic hemangiomas using the updated International Society for the Study of Vascular Anomalies classification and to create a set of guidelines for their diagnostic evaluation and monitoring. STUDY DESIGN: We used a rigorous, transparent consensus protocol defined by an approved methodology, with input from multiple pediatric experts in vascular anomalies from hematology-oncology, surgery, pathology, radiology, and gastroenterology. RESULTS: In the first section, we define the subtypes of hepatic hemangiomas based on the clinical course, histology, and radiologic characteristics. We recommend against using the term "hemangioma" for any vascular malformations affecting the liver or any hypervascular tumors that are not characterized by the approved definitions. We recommend against using the term "hemangioendothelioma" for infantile or congenital hemangioma. The following 2 sections dedicated to infantile hepatic hemangioma and to congenital hepatic hemangioma individually describe these subtypes in further detail, including complications to be considered during monitoring and respectively recommended screening evaluations. CONCLUSIONS: Although institutional variations may exist for specific clinical details, a clear understanding of the diagnosis of hepatic hemangiomas affecting children and the possible complications that require screening during the monitoring period should be standard. As children with hepatic hemangiomas are managed by different medical and surgical specialties, we offer an expert opinion multidisciplinary consensus based on current literature and on data extracted from the liver hemangioma registry.


Assuntos
Hemangioma/classificação , Hemangioma/diagnóstico , Neoplasias Hepáticas/classificação , Neoplasias Hepáticas/diagnóstico , Pré-Escolar , Feminino , Hemangioendotelioma , Humanos , Lactente , Recém-Nascido , Imagem por Ressonância Magnética , Masculino , Programas de Rastreamento , Oncologia , Pediatria/normas , Guias de Prática Clínica como Assunto , Sistema de Registros , Ultrassonografia Doppler , Estados Unidos , Malformações Vasculares/classificação , Malformações Vasculares/diagnóstico
15.
J Hepatobiliary Pancreat Sci ; 25(8): 359-369, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30160060

RESUMO

Congenital portosystemic shunt (CPS) is classified into type I (congenital absence of the portal vein) and type II, depending on the presence or absence of the intrahepatic portal vein. Reports still exist on cases in which psychiatric diseases or mental retardation was diagnosed or cases in which diagnosis and treatment are not performed until severe pulmonary complications occur, indicating the need to recognize CPS. Herein, we reviewed epidemiology, etiology, classification, symptom, diagnosis, and treatment based on clinical view points of CPS. For clinical view points, classification according to (1) the presence or absence of the intrahepatic portal venous system (IPVS) and (2) the extrahepatic or intrahepatic of shunt sites, facilitates the understanding of pathophysiological conditions and is useful in selecting a treatment for symptomatic CPS. Radiological and pathological examinations are important in IPVS evaluations, and IPVS evaluations are currently essential to make diagnoses by portography with balloon occlusion and liver biopsy. Symptomatic CPS (hepatic nodular lesions, portosystemic encephalopathy, and pulmonary complications, etc.) is an indication of treatment by shunt closure, but an indication of treatment for asymptomatic CPS is the challenge going forward.


Assuntos
Veia Porta/anormalidades , Malformações Vasculares , Humanos , Veia Porta/cirurgia , Malformações Vasculares/classificação , Malformações Vasculares/diagnóstico , Malformações Vasculares/epidemiologia , Malformações Vasculares/terapia
16.
Rofo ; 190(9): 825-835, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29874693

RESUMO

BACKGROUND: Vascular anomalies are a diagnostic and therapeutic challenge. They require dedicated interdisciplinary management. Optimal patient care relies on integral medical evaluation and a classification system established by experts in the field, to provide a better understanding of these complex vascular entities. METHOD: A dedicated classification system according to the International Society for the Study of Vascular Anomalies (ISSVA) and the German Interdisciplinary Society of Vascular Anomalies (DiGGefA) is presented. The vast spectrum of diagnostic modalities, ranging from ultrasound with color Doppler, conventional X-ray, CT with 4 D imaging and MRI as well as catheter angiography for appropriate assessment is discussed. RESULTS: Congenital vascular anomalies are comprised of vascular tumors, based on endothelial cell proliferation and vascular malformations with underlying mesenchymal and angiogenetic disorder. Vascular tumors tend to regress with patient's age, vascular malformations increase in size and are subdivided into capillary, venous, lymphatic, arterio-venous and combined malformations, depending on their dominant vasculature. According to their appearance, venous malformations are the most common representative of vascular anomalies (70 %), followed by lymphatic malformations (12 %), arterio-venous malformations (8 %), combined malformation syndromes (6 %) and capillary malformations (4 %). CONCLUSION: The aim is to provide an overview of the current classification system and diagnostic characterization of vascular anomalies in order to facilitate interdisciplinary management of vascular anomalies. KEY POINTS: · Vascular anomalies are comprised of vascular tumors and vascular malformations, both considered to be rare diseases.. · Appropriate treatment depends on correct classification and diagnosis of vascular anomalies, which is based on established national and international classification systems, recommendations and guidelines.. · In the classification, diagnosis and treatment of congenital vascular anomalies, radiology plays an integral part in patient management.. CITATION FORMAT: · Sadick M, Müller-Wille R, Wildgruber M et al. Vascular Anomalies (Part I): Classification and Diagnostics of Vascular Anomalies. Fortschr Röntgenstr 2018; 190: 825 - 835.


Assuntos
Doenças Raras , Malformações Vasculares/classificação , Malformações Vasculares/diagnóstico por imagem , Neoplasias Vasculares/diagnóstico por imagem , Anormalidades Múltiplas/classificação , Anormalidades Múltiplas/diagnóstico por imagem , Anormalidades Múltiplas/terapia , Adulto , Malformações Arteriovenosas/classificação , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Criança , Diagnóstico Diferencial , Diagnóstico por Imagem/métodos , Humanos , Anormalidades Linfáticas/classificação , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/terapia , Síndrome , Malformações Vasculares/terapia , Neoplasias Vasculares/classificação , Neoplasias Vasculares/terapia
17.
Asia Pac J Ophthalmol (Phila) ; 7(5): 356-363, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29633786

RESUMO

The recent International Society for the Study of Vascular Anomalies (ISSVA) classification of vascular anomalies can be applied to orbital lesions, dividing them into vascular tumors and vascular malformations. Orbital cavernous hemangiomas are probably best considered cavernous venous malformations under this classification. Management of symptomatic lesions can be with surgical excision or stereotactic fractionated radiotherapy in selected cases. Beta-blockers including propranolol and topical timolol maleate represent first-line therapy for infantile hemangiomas, although surgery has a role in selected cases. Orbital venous-lymphatic malformations are problematic but with improved imaging, neuroradiological intervention, and a multidisciplinary approach to management, outcomes are improving.


Assuntos
Hemangioma/classificação , Órbita , Neoplasias Orbitárias/classificação , Malformações Vasculares/classificação , Hemangioma/patologia , Hemangioma/terapia , Hemangioma Cavernoso/classificação , Humanos , Órbita/irrigação sanguínea , Órbita/patologia , Neoplasias Orbitárias/patologia , Neoplasias Orbitárias/terapia , Malformações Vasculares/patologia , Malformações Vasculares/terapia
18.
Bull Cancer ; 105(6): 610-625, 2018 Jun.
Artigo em Francês | MEDLINE | ID: mdl-29571951

RESUMO

Superficial vascular anomalies constitute a large group of malformative and tumoral conditions developed from all types of vessels. Vascular tumors are the result of cellular hyperplasia, whereas vascular malformations (VMs) are constituted of dysplastic vessels. The classification from International Society for the Study of Vascular Anomalies (ISSVA) is based on this pathogenic difference. The most common vascular tumor is infantile hemangioma, which treatment, when necessary, is propranolol. Congenital hemangiomas and tumors that might be complicated with Kasabach-Merritt phenomenon, i.e. deep thrombocytopenia, are much rarer. Management of Kasabach-Merritt phenomenon is now largely based on sirolimus. Low-flow VMs include capillary, venous and lymphatic malformations; arteriovenous malformations are high-flow malformations. These different types of VMs might be combined. Currently, there is an increasing work in delineating the different entities based on molecular findings. Treatment of VMs depends on the impairment linked to them, and is decided case by case, in pluridisciplinary consultations. Interventional treatments, especially surgery and sclerotherapy, are usually partially efficient, and management of patients with VMs increasingly involves medical drugs. First-line treatment of coagulation disorders associated with venous malformations is based on low molecular weight heparin; sirolimus seems efficient in hemorrhagic complications refractory to usual treatment. Sirolimus is about to become the standard treatment in painful inflammatory manifestations of mixed and/or complicated lymphatic malformations.


Assuntos
Neoplasias de Tecido Vascular , Doenças Raras , Adolescente , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Malformações Arteriovenosas/classificação , Malformações Arteriovenosas/terapia , Criança , Pré-Escolar , Hemangioma/complicações , Hemangioma/tratamento farmacológico , Humanos , Lactente , Síndrome de Kasabach-Merritt/tratamento farmacológico , Neoplasias de Tecido Vascular/classificação , Neoplasias de Tecido Vascular/complicações , Neoplasias de Tecido Vascular/terapia , Propranolol/uso terapêutico , Doenças Raras/classificação , Doenças Raras/complicações , Doenças Raras/terapia , Sirolimo/uso terapêutico , Malformações Vasculares/classificação , Malformações Vasculares/terapia , Vasodilatadores/uso terapêutico
20.
Int Angiol ; 37(2): 127-142, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29424187

RESUMO

INTRODUCTION: Vascular malformations are congenital lesions with complex clinical presentations and management. Their classification and treatment options have considerably changed throughout the years, with conflicting evidence in the literature. In this article, we aim to review the classification, diagnosis and treatment of the main vascular malformations. EVIDENCE ACQUISITION: A thorough non-systematic review of the literature was conducted using PubMed/Medline. Seventy-nine articles were selected and included, according to their scientific relevance and relation with the subject. EVIDENCE SYNTHESIS: Vascular malformations occur due to errors during vasculogenesis. They are present at birth, though they may not be apparent until later in life. These malformations are most frequently found in the head and neck, but can occur in any part of the body. They can be divided according to the predominant vessel type into arteriovenous, venous, capillary and lymphatic. Combined malformations occur when more than one type of vessel is present. Clinical presentation is variable and depends on the type of malformation, as well as location, size and relation with other structures. Symptoms such as ischemia, swelling, pain, thrombosis, deformity and functional impairment can be caused by these lesions. The diagnosis of vascular malformations is based in both clinical presentation and complementary imaging techniques, with special emphasis on magnetic resonance imaging. Depending on the malformation and clinical presentation, treatment may be medical or interventional, by means of either interventional techniques or surgery. CONCLUSIONS: Vascular malformations are a complex group of pathologies, with different clinical presentations and treatment options, and therefore management by a multi-disciplinary team is essential. Their cure is often challenging and when not possible, treatment should aim at symptomatic control and improvement of patient's quality of life.


Assuntos
Procedimentos Endovasculares , Malformações Vasculares , Procedimentos Cirúrgicos Vasculares , Procedimentos Endovasculares/efeitos adversos , Humanos , Qualidade de Vida , Fatores de Risco , Resultado do Tratamento , Malformações Vasculares/classificação , Malformações Vasculares/complicações , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/terapia , Procedimentos Cirúrgicos Vasculares/efeitos adversos
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