Surgical management of low flow vascular malformations

Abstract

Background: Percutaneous treatment has been widely used in low flow vascular malformations. However, surgery still has an important role in the management of these patients.Objective: The aim of this study is to assess the indications for surgery in low flow vascular malformations, as well as the safety, efficacy, and recurrence rate.Patients and Methods: A total of 33 patients with low flow vascular malformations were enrolled in the study. Duplex ultrasonography and magnetic resonant angiography was performed in all the cases. Selection criteria included significant soft tissue component, localized accessible lesions, suspicion of malignancy, persistent embryonic veins, residual lesions after sclerotherapy, and failure or development of complications of sclerotherapy.Results: All the selected patients underwent complete surgical excision. Histopathological examination confirmed the preoperative diagnosis and excluded malignancy in all the patients. One patient developed postoperative bleeding that was managed by external compression and another patient developed necrosis of the edges of skin flaps that was managed by dressing. No recurrence was detected.Conclusion: Surgical excision of low flow vascular malformations is a valid option in selected patients.