Vascular Malformations : Advances and Controversies in Contemporary Management book cover
1st Edition

Vascular Malformations
Advances and Controversies in Contemporary Management

ISBN 9780367250126
Published January 2, 2020 by CRC Press
442 Pages 192 Color & 103 B/W Illustrations

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Book Description

This new book on vascular malformations brings together international experts to present advances and discuss controversies in the multidisciplinary management of patients with congenital vascular malformations.

Major advances in recent years in medical genetics, and tremendous progress in the fields of imaging and minimally invasive percutaneous interventions have revolutionized both evaluation and management of vascular malformations. The six major parts of this state of the art book ensure that the reader has the most up to date valuable clinical information to ensure the delivery of world class clinical practice. Beautifully illustrated with color line drawings, numerous photographs and informative tables, the advances and controversies of the full spectrum of vascular malformations are presented in 90 definitive chapters.

Vascular Malformations brings new information and unparalleled insights to vascular specialists and physicians, trainees and allied health professionals who participate in the care of patients with vascular malformations, either in a private practice setting or at a major institution in an interdisciplinary vascular center.

Table of Contents

Foreword Hugo Partsch

Preface BB Lee, Peter Gloviczki & Francine Blei

Part 1. Congenital Vascular Malformations (CVMs) in General

Section 1. Definition & Classification

Chapter 1. ISSVA Classification: Controversy with the benefit and liability.

Raul Mattassi

Chapter 2. Hamburg Classification: Controversy with the benefit and liability.

Peter Gloviczki & David Driscoll

Chapter 3. Syndromic classification of Congenital Vascular Malformations: how useful is it?

Francine Blei

Chapter 4. Consensus on the contemporary classification.

BB Lee & Leonel Villavicencio

Section 2. Diagnosis

Chapter 5. How extensive study should be included in initial assessment for the Congenital Vascular Malformations?

BB Lee & James Laredo

Chapter 6. Should hemangiomas be included in the initial differential diagnosis for Congenital Vascular Malformations?

Francine Blei

Chapter 7. How much the genetic studies should be incorporated for Venous Malformations and Arterio-Venous Malformations assessment, and when?

Sandro Michelini, Stefano Paolacci & Matteo Bertelli

Chapter 8. Indications for genetic testing in the evaluation of Lymphatic and Hemolymphatic Malformations.

Stanley G. Rockson

Section 3. Management

Chapter 9. The importance of interdisciplinary team approach for evaluation and

management of Vascular Malformations.

Megha M. Tollefson, Peter Gloviczki & David Driscoll

Chapter 10. How will genetics influence the management of Vascular Malformations?

Francine Blei

Part 2. Arterio-Venous Malformations (AVMs)

Section 4. Definition & Classification

Chapter 11. Confusion with Arterio-Venous fistula versus Arterio-Venous Malformation of ISSVA Classification.

Dirk Loose

Chapter 12. Nidus or no nidus: Is it a crucial issue for diagnostic assessment for the Arterio-Venous Malformations?

Furuzan Numan

Chapter 13. New classification of the Arterio-Venous Malformations based on arteriographic findings: How much worthy?

YoungSoo Do & Kwang Bo Park

Section 5. Diagnosis

Chapter 14. Arteriographic assessment: Is it still a gold standard for the Arterio-Venous Malformations diagnosis?

Hendrik von Tengg-Kobligk, Iris Baumgartner, Sabrina Frey & Dominik Obrist

Chapter 15. Ultrasonographic assessment: New role for the Arterio-Venous Malformations. How far can it be implied?

Erica Menegatti & Sergio Gianesini

Chapter 16. Magnetic Resonance (MR) Angiography and/or Computed Tomography (CT) Angiography: New gold standard for the Arterio-Venous Malformations?

Massimo Vaghi

Chapter 17. Transarterial Lung Perfusion Scintigraphy (TLPS): New role for the follow up


Raul Mattassi

Section 6. Management - 1

Chapter 18. Do all the Arterio-Venous Malformations mandate the therapy? Is there any contraindication for the therapy?

BB Lee & James Laredo

Chapter 19. How much is too much for the Arterio-Venous Malformation management?

Young-Wook Kim

Chapter 20. Ethanol sclerotherapy- Is it gold standard for the Arterio-Venous Malformation management?

Iris Baumgartner, Mihai Constatntinescu, Jochen Rössler & Hendrik von Tengg

Chapter 21. N-Butyl Cyanoacrylate versus Onyx embolotherapy.

Furuzan Numan

Section 7. Management - 2

Chapter 22. Surgical therapy combined with embolo/sclerotherapy - Multidisciplinary


Paul Marji, James Laredo & BB Lee

Chapter 23. Indication for the amputation for the Arterio-Venous Malformation - proper option?

Young-Wook Kim

Chapter 24. How much pharmacological therapy can be incorporated to the Arterio-Venous Malformation management?

Jochen Karl Rössler & Iris Baumgartner

Chapter 25. Secondary changes in Arterio-Venous Malformations: arteries, veins, tissues, bones; when do they have to be treated?

Dirk Loose

Part 3. Venous Malformations (VMs)

Section 8. Definition & Classification

Chapter 26. (Capillary & Cavernous) Hemangioma and Venous Malformations.

BB Lee & James Laredo

Chapter 27. Angiographic classification of the Venous Malformations based on venous drainage status: How much worthy?

Kwang Bo Park & Young Soo Do

Section 9. Diagnosis

Chapter 28. Ultrasonographic assessment: Mandatory test to lead the assessment of the Venous Malformations?

Pier Luigi Antignani

Chapter 29. Conventional and Dynamic Contrast Enhanced Magnetic Resonance Imaging (dceMRI) and/or Magnetic Resonance Venography: diagnostic modalities with different objectives? Can they replace phlebography?

Jovan Markovic & Cynthia Shortell

Chapter 30. Computed Tomography (CT) and CT Venography: how are these modalities different from Magnetic Resonance Imaging (MRI) for evaluation of Venous Malformations?

Jovan Markovic & Cynthia Shortell

Chapter 31. Whole Body Blood Pool Scintigraphy (WBBPS) - Special role for the management of Venous Malformations?

Raul Mattassi

Section 10. Management -1

Chapter 32. Do all the Venous Malformations require treatment?

Kurosh Parsi & Mina Kang

Chapter 33. How much is too much for the Venous Malformations management?

Pier Luigi Antignani

Chapter 34. What is the first option for the Venous Malformations management?

Sarah Bernhard, Aleksandra Tuleja, Jochen Rössler & Iris Baumgartner

Chapter 35. Ethanol sclerotherapy- Is it gold standard for the Venous Malformations management as well?

YoungSoo Do

Chapter 36. Foam Sclerotherapy- First option for Venous Malformations?

Kurosh Parsi & Mina Kang

Chapter 37. Considerations regarding feasibility, safety and efficacy of N-Butyl Cyanoacrylate (n-BCA) and Onyx embolization for the treatment of Venous Malformations.

Jovan Markovic & Cynthia Shortell

Section 11. Management -2

Chapter 38. Surgical therapy of Venous Malformations combined with embolo/sclerotherapy: How much and when?

Dirk Loose

Chapter 39. How aggressive the management of vascular bone syndrome caused by the Venous Malformations should be?

Raul Mattassi

Chapter 40. To what extent should anticoagulation therapy be considered to the Venous Malformations?

Alfonso Tafur, Evi Kalodiki & Jawed Fareed

Chapter 41. How to approach on Marginal Vein combined with deep vein hypoplasia/ aplasia?

Dirk Loose

Chapter 42. Indication for the amputation for extensive Venous Malformations - proper


Dirk Loose

Chapter 43. How much pharmacological therapy can be incorporated to the Venous Malformations management?

Francine Blei

Part 4. Lymphatic Malformations (LMs)

Section 12. Definition & Classification

Chapter 44. Confusion on the Terminology- Primary Lymphedema and Lymphangioma /Lymphatic Malformations

James Laredo & BB Lee

Chapter 45. Contemporary diagnosis of Primary Lymphedema and Lymphatic Malformations

Stanley G. Rockson

Chapter 46. Clinical staging of lymphedema - How practical for clinical management of

Primary Lymphedema?

Sandro Michelini, Alessandro Fiorentino, Alessandro Failla & Giovanni Moneta

Chapter 47. Laboratory (lymphoscintigraphic) staging- Guideline?

BB Lee & James Laredo

Section 13. Diagnosis

Chapter 48. Ultrasonographic assessment of the Lymphatic Malformations : Lymphangioma & Primary Lymphedema - A new role for the diagnosis?

Erica Menegatti & Sergio Gianesini

Chapter 49. Radionuclide Lymphoscintigraphy (LSG) - Gold standard for the assessment of

the Lymphatic Malformations: Lymphangioma & Primary Lymphedema, BOTH?

Vaughan Keeley

Chapter 50. Magnetic Resonance Imaging (MRI) and Magnetic Resonance Lymphangiography of Primary Lymphedema - A new gold standard?

NingFei Liu

Chapter 51. Indocyanine Green (ICG) Fluorescent Lymphography- Clinical implementation

Takumi Yamamoto

Chapter 52. Oil Contrast Lymphangiography - New role for the surgical candidate?

Francesco Boccardo, Sara Dessalvi, Campisi Corrado Cesare & Campisi Corradino

Chapter 53. Fluorescent microlymphangiography: Controversial - confusion and neglected problems

Claudio Allegra, Michelangelo Bartolo & Salvino Bilancini

Chapter 54. Can Indocyanine Green (ICG) Fluorescent Lymphography replace the role of Lymphoscintigraphy (LSG)?

Takumi Yamamoto

Chapter 55. How to differentiate between the Lymphedema and Lipedema. How to rule out the Lipedema?

Gyozo Szolnoky

Section 14. Management- 1: Primary Lymphedema

Chapter 56. Manual Lymphatic Drainage (MLD) - Myth?

Isabel Forner Cordero & Jean Paul Belgrado

Chapter 57. Compression therapy- Optimal Pressure? Bandage versus stocking.

Isabel Forner Cordero & Jean Paul Belgrado

Chapter 58. Sequential Intermittent Pneumatic Compression (SIPC) - Rationale? How much it can be incorporated to compression therapy?

Isabel Forner Cordero & Jean Paul Belgrado

Chapter 59. Reconstructive surgery: Lymphovenous anastomosis versus lymph-node transplantation. Can they stay as an independent therapy option? Indications & Contraindications?

Corradino Campisi, Francesco Boccardo, Melissa Ryan, Michele Maruccia, Fabio Nicoli, Pietro Di Summa & Corrado Cesare Campisi

Chapter 60. Excisional surgery: when and how much it can be incorporated?

Justin Chin-Bong Choi, James Laredo & BB Lee

Chapter 61. Multidisciplinary approach with liposuction in Primary Lymphedema: Is there a difference compared to patients with Secondary Lymphedema?

Robert Damstra & Håkan Brorson

Chapter 62. How much pharmacological therapy can be incorporated to the Primary Lymphedema management?

Vaughan Keeley and Neil Piller

Chapter 63. What is the difference in the management of Primary Lymphedema between the

adults and children, and how much?

Miguel Amore & Cristobal Papendieck

Chapter 64. How to manage the Lipedema involved to Primary lymphedema?

Gyozo Szolnoky

Chapter 65. How to assess the response/efficacy of manual lymphatic drainage and

compression therapy.

Gyozo Szolnoky

Chapter 66. How to assess the efficacy of Lipedema management involved to the


Gyozo Szolnoky

Chapter 67. The pathophysiology behind adipose tissue deposition in Lymphedema and how

liposuction completely can reduce the excess volume

Håkan Brorson

Chapter 68. Liposuction- can it be implied to the management of Lipedema?

Robert Damstra & Tobias Bertsch

Section 15. Management-2 : Lymphangioma

Chapter 69. How to manage the lymphatic leakage involved in Lymphangioma?

Xi Yang, Xiaoxi Lin & NingFei Liu,

Chapter 70. How to manage recurrent infections involved to Lymphangioma?

Xi Yang, Xiaoxi Lin MD &NingFei Liu

Chapter 71. How aggressive chyloreflux (e.g. chyluria, chyloascites, chylothorax, chyle-

leakage) should be handled?

Miguel Amore & Cristobal Papendieck

Chapter 72. Pharmacological considerations for Lymphatic Malformation management

Stanley G. Rockson

Chapter 73. How much different the management of Lymphangioma among

pediatric/neonatal age group should be?

Miguel Amore & Cristobal Papendieck

Chapter 74. Peculiarities in surgical treatment in childhood; can we ignore?

Juan Carlos López Gutiérrez

Part 5. Combined vascular malformations: Hemo-lymphatic

Malformations / Klippel-Trenaunay Syndrome (KTS)

Section 16. Diagnosis

Chapter 75. What extent the diagnostic study should be extended for the Arterio-Venous Malformations involvement to Klippel-Trenaunay Syndrome assessment?

Massimo Vaghi

Chapter 76. How much the diagnostic investigations should incorporate visceral

involvement for Klippel-Trenaunay Syndrome?

Massimo Vaghi

Section 17. Management -1

Chapter 77. How to decide the priority for the treatment among the Congenital Vascular Malformation components?

James Laredo & BB Lee

Chapter 78. The management of Vascular Bone Syndrome: how aggressive and when?

Jong Sup Shim & Young-Wook Kim

Chapter 79. How aggressive to manage the varicose veins involved to Klippel-Trenaunay Syndrome?

Sergio Gianesini and Erica Menegatti

Chapter 80. How aggressive the management of the indolent stasis ulcer should be done

in Klippel-Trenaunay Syndrome?

Sergio Gianesini & Erica Menegatti

Section 18. Management -2

Chapter 81. How aggressive the gastrointestinal bleeding among Klippel-Trenaunay Syndrome should be handled?

Massimo Vaghi

Chapter 82. Therapeutic considerations for infection, sepsis and lymphatic leak management in patients with Klippel-Trenaunay Syndrome

Jovan Markovic & Cynthia Shortell

Chapter 83. How to manage the coagulopathy in Klippel-Trenaunay Syndrome?

Alfonso Tafur, Evi Kalodiki & Jawed Fareed

Chapter 84. Klippel-Trenaunay Syndrome: Pain and Psychosocial Considerations

Jamison Harvey, Megha Tollefson, Peter Gloviczki & David Driscoll

Chapter 85. Klippel-Trenaunay Syndrome and Complex Venous Malformations: Should a multi-modality approach be the standard of care? - Endovenous Laser Ablation (EVLA), Tumescent-assisted Ultrasound-Guided Sclerotherapy (TUGS), n-BCA and Power Phlebectomy.

Kurosh Parsi & Mina Kang

Part 6. Capillary Malformations (CMs)

Section 19. Diagnosis

Chapter 86. Is this a Capillary Malformation? - Differential diagnosis and other dermal vascular lesions and eruptions.

Kurosh Parsi & Mina Kang

Chapter 87. How much the diagnostic assessment for Port Wine Stains should be extended for other Vascular Malformations to exist together?

Peter Berlien

Section 20. Management

Chapter 88. Port Wine Stains/ Capillary Malformations among the Klippel-Trenaunay Syndrome patients: How to select the candidate for the laser therapy and when?

Peter Berlien

Chapter 89. What extent the surgical excision should be implemented to Port Wine Stains and when?

Peter Berlien

Chapter 90. To what extent the laser therapy and surgical excision could be combined for the Port Wine Stains management?

Peter Berlien

Epilogue BB Lee

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Byung-Boong Lee MD PhD FACS, Professor of Surgery, Department of Surgery, Division of Vascular Surgery, George Washington University, Washington, District of Columbia, USA.

Peter Gloviczki MD FACS, Joe M. and Ruth Roberts Professor of Surgery (Emeritus), Chair, Division of Vascular, and Endovascular Surgery (Emeritus), Director, Gonda Vascular Center (Emeritus), Mayo Clinic, Rochester, Minnesota, USA. Editor-In-Chief, Journal of Vascular Surgery.

Francine Blei MD, Director, Vascular Anomalies Program of Lenox Hill Hospital, New York City, New York, USA.