Understanding Vascular Anomalies and Malformations

Symptoms

The symptoms of vascular anomalies can vary depending on the type and location of the anomaly. Some common symptoms of vascular anomalies include:

Swelling or a mass: Vascular anomalies can cause swelling or a mass to form on the skin or in the body.
Pain: Some vascular anomalies can cause pain, particularly if they are located near a joint or in a sensitive area of the body.
Skin changes: Vascular anomalies can cause changes in the color or texture of the skin, such as redness or bruising.
Difficulty breathing: In some cases, vascular anomalies can cause difficulty breathing or shortness of breath.
Headaches: Vascular anomalies in the head or neck can cause headaches.
Vision changes: Vascular anomalies near the eyes can cause vision changes, such as blurriness or double vision.
Fatigue: Some people with vascular anomalies may experience fatigue or tiredness.

Causes

A non-hereditary vascular development disorder causes vascular anomalies (also known as vascular malformations). They are generally not genetic, and family history is not usually an indicator of whether or not an increased number of enlarged blood vessels will develop in one particular location. Vascular anomalies come in three different varieties.

Vascular Malformations

Vascular malformations are named for the type of blood vessel most affected. They are present at birth; however, they may take several years to become apparent. Types of vascular malformations include:

Capillary vascular malformations: known as port-wine stains
Arterial (arteries) malformations
Venous (veins) malformations
Arteriovenous (arteries and veins) malformations
Spider angiomas
Angiofibromas

Complex combined vascular malformations may accompany a genetic syndrome, such as Sturge-Weber syndrome, Klippel-Trenaunay syndrome, Parkes-Weber syndrome, hereditary hemorrhagic telangiectasia, CLOVES syndrome, or Proteus syndrome.

Vascular Tumors

Vascular tumors are most often benign, meaning they are non-cancerous and do not invade other tissues. Infantile hemangiomas are the most common form; they generally grow for 6-12 months and then begin to regress (shrink in size). Types of vascular tumors include:

Infantile hemangiomas
Congenital hemangiomas
Pyogenic granulomas
Glomangiomas
Kaposi's sarcoma
Angiosarcoma
Hemangioendothelioma

Lymphatic Malformations

A final type of vascular abnormality is a lymphatic malformation, which affects the lymph vessels and can lead to enlarged, fluid-filled cysts and swelling. These most commonly affect the head and neck and become present from birth to two years of age.

Risk Factors

There are several factors that may increase the risk of developing vascular anomalies, including:

Genetic factors: Some people may have a genetic predisposition to developing vascular anomalies.
Pregnancy: Pregnancy can increase the risk of developing vascular anomalies, particularly in the second trimester.
Certain medications: Some medications, such as anticonvulsants and isotretinoin, may increase the risk of developing vascular anomalies.
Certain medical conditions: Certain medical conditions, such as genetic syndromes and autoimmune disorders, may increase the risk of developing vascular anomalies.
Environmental factors: Exposure to certain environmental factors, such as radiation or chemicals, may increase the risk of developing vascular anomalies.

Diagnosing Vascular Anomalies

Most vascular anomalies can be diagnosed by your doctor with a physical examination. Your doctor may utilize imaging tests (MRI, angiography, or ultrasound) to provide additional information about the extent of the malformation.

The signs of a vascular anomaly may be evident at birth or might show up later in a child's life. Hormonal changes due to puberty, trauma, or infection may cause them to grow or enlarge. These signs include:

Color changes to the skin (blue, pink, red, blue, purple)
Raised red lesions with a rapid growth cycle
Pain
Swelling
Bleeding
Ulceration
Misshapen extremities, such as hands or face

Vascular Treatments

If a birthmark or other vascular anomaly is not causing your child any discomfort, pain, or bleeding, you may decide to forgo treatment options. However, if the anomaly has progressed to cause problems for your child, a vascular malformation specialist can help you decide on a suitable treatment option.

Medications

Propranolol is a beta-blocker medication typically used to treat high blood pressure and other heart-related problems. Propranolol is used to reduce the size and redness of infantile hemangiomas. Corticosteroids, immunosuppressive medications, and, in some cases, chemotherapeutic medications have also been used to treat anomalies.

Laser Treatments

Laser treatments have been found to be up to 92.8% effective over the course of 3 or more treatments for venous malformations, which look like a blue mass of veins. Laser treatments may be performed under general anesthesia or sleep sedation to help keep children comfortable and at ease during the procedure.

Sclerotherapy

Sclerotherapy is commonly used to treat problematic venous and lymphatic malformations. Sclerotherapy injects a solution directly into the vein that causes it to scar and collapse, forcing the blood to reroute into healthier veins. Over time, the damaged vein is reabsorbed into surrounding tissue and fades away. This procedure is also used to treat varicose and spider veins. It may require multiple procedures to get complete results.

Surgical Treatment for Vascular Anomalies

Surgical removal may accompany other forms of vascular malformation treatment, including sclerotherapy, medications, or laser treatments. Surgical removal is the standard treatment for lymphatic malformations and may also be recommended for hemangiomas, venous malformations, and arteriovenous malformations. This is typically an outpatient procedure performed under general anesthesia and may be performed 24 to 48 hours after sclerotherapy treatment.

Your vascular malformation specialist will provide detailed instructions before, during, and after a treatment. Oftentimes, treating a vascular anomaly requires multiple or combined treatment modalities. Each will come with its own treatment and recovery plan. After surgical removal, it can take up to 6 weeks to resume full daily activities.

Our Doctors

At the Plastic Surgery Center at the Institute for Advanced Reconstruction, our vascular malformation specialists are experienced in treating birthmarks and blood vessel growths. Our team will develop a personalized treatment plan for your child that delivers long-lasting results.

Physician

Jonathan Weiswasser

MD, FACS

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Insurance Information

The Institute for Advanced Reconstruction participates in a wide range of insurance plans, including those listed below. However, each physician has their own accepted insurance and hospital affiliations. Before scheduling an appointment, please contact your insurance carrier to confirm that your provider is in-network.

If we are not an in-network provider, our friendly insurance specialists will help you find the most coverage available for your treatment.

Horizon Blue Cross Blue Shield of New Jersey
Medicare
Railroad Medicare
Aetna
Cigna
United Healthcare
Oxford (Freedom, Liberty)
MagnaCare

Patient Resources

Learn more about what to expect when it comes to surgical procedures and treatments at the Institute for Advanced Reconstruction by visiting our patient resource page.

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