Vascular malformation basic knowledge

What is a vascular malformation?

Vascular malformation is a congenital disease. It contains abnormal blood vessels within the lesion. There are many confusing classification present for vascular malformation, mostly it’s confusing between heamangioma & vascular malformation . Many vascular malformation lesions name given in the memory of scientist who have detected it first. All this multiple classifications makes this disease more complex for understanding. I follow general classification for understanding disease & yakes classification for treatment of disease.

In general classification, Vascular malformation is further classified according to flow inside the lumen in two types. 1)If flow is high than high flow vascular malformation . (2) if flow is slow inside the lesion than slow flow vascular malformation.

High flow vascular malformation

High flow vascular malformation has very high velocity pulsatile flow. It has only one type that is arterio-venous malformation

Arterio-venous malformation has arterio-venous communication without any intertwining capillary bed. This communication is called nidus & it’s very important to destroy nidus for it’s curative treatment. Yake’s classification is important classification based on nidus & outflow tract.

vascular malformation

Slow flow vascular malformation

Slow flow vascular malformation has very low velocity non-pulsatile flow. It is further subclassified into three types.

  1. Venous malformation.
  2. lymphatic malformation.
  3. lympho-venous malformation.

Why do these vascular malformations occur?

These are all present at birth and become apparent at different ages. During developmental phase in embryo, different types of blood vessels can not be differentiated ….which leads to vascular malformation. Vascular malformation lesion has multiple vessel lumens within it. And this lumen has inner lining which has embryological characteristics. While treating this lesion, primary target is to destroy this inner lining , if one fails to destroy it than it will regrow with neovascularisation & recanalisation of blocked lumen . This recurrence of lesion shows faster tumor growth.

What are the symptoms of a vascular malformation?

These vascular malformations can cause a variety of symptoms depending on the location in the body:

Venous malformation may cause pain where ever they are located. Venous and lymphatic malformations may cause a lump under the skin. There may be an overlying birthmark on the skin. Bleeding or lymph fluid leaking may occur from skin lesions. Lymphatic malformations tend to become infected, requiring repeated antibiotic treatments. Venous and lymphatic malformations may be associated with a syndrome called Klippel-Trenaunay Syndrome.

malformation on leg

Arteriovenous malformations may cause pain. They are also more stressful on the heart because of the rapid shunting of blood from arteries to veins. Depending on their location, they may also result in bleeding (for example from the bowels, from the uterus or from the bladder).

Yakes classification

yakes classification is based on angioarchitectures of av malformation. It’s useful for planning of treatment