Congenital Venous Malformations

Congenital venous malformations (VM) make up the majority (about 65%) of congenital vascular malformations (CVM). A CVM is present atbirth and is a malformed vessel that is the result of developmental arrest during the formation of the embryo. This defect continues to grow over time at a rate that is proportional to the growth rate of the body. The incidence of CVM has been reported at 1.2%.

CVM is not to be confused with a hemangioma which is a vascular tumor.

If VM is suspected, a complete history and physical should be done, since VM lesions can occur anywhere on the body. Ultrasound as well as MRI and other scans may need to be done. The history may reveal blood clots and thrombophlebitis (vein inflammation). There may be associated other medical problems, often with the musculoskeletal system.

Treatment of VM is more complex than treatment of standard venous disease. Very often a multidisciplinary approach is need. Surgery, endovenous laser, and endovenous sclerotherapy are all tools that can be used in treatment. Non vascular specialties (eg; orthopedic surgery) may be utilized for complete treatment.

Patients need to realize there is a relatively high incidence of recurrence following treatment. Long term follow-up and further treatment are often required.

Hemangiomas

Hemangioma is not a venous problem. A hemangioma is a vascular tumor that is not present at birth. It is also called an infantile or neonatal hemangioma, appearing in the early neonatal period. It presents on the skin and originates from epithelial cells.

It has a distinctive growth cycle. There is a rapid proliferative phase followed by an involutional phase. The regression is slow and is usually complete by age 5-10 years. It affects females over males at a ratio of 3-5:1.

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