Understanding vascular malformations (“Birthmarks”)

Vascular malformations are abnormal bundles of blood vessels that are present from birth. These can involve blood vessels (big and small, veins and arteries) as well as lymph vessels and may occur anywhere in the body, including the skin, face, arms, or legs.

Some vascular malformations—called arteriovenous malformations (AVMs)—involve direct connections between arteries and veins without the normal capillary network. This can lead to increased blood flow and pressure within the affected area. Some of these malformations are very complex, and may require multiple treatment sessions.

Depending on their type and location, vascular malformations can cause:

1. Pain or discomfort
2. Swelling or a visible lump
3. Skin discoloration or warmth
4. Bleeding
5. Functional problems (e.g. difficulty with movement or cosmetic concerns)

Vascular Malformation Treatment (VMT) with sclerotherapy or embolization is a minimally invasive, image-guided treatment designed to reduce or block abnormal blood flow within these lesions.

Common conditions treated

1. Symptomatic vascular malformations (venous, lymphatic or arteriovenous) causing pain or swelling
2. Bleeding or ulcerated vascular lesions
3. Cosmetic or functionally limiting vascular malformations

Who may benefit

You may be suitable for embolisation if you:

1. Have a diagnosed vascular malformation causing symptoms
2. Experience pain, swelling, or recurrent bleeding
3. Have a lesion that is growing or becoming more symptomatic
4. Wish to avoid or minimise surgery
5. Are seeking a minimally invasive treatment option

How the procedure Is performed

1. Performed by an interventional radiologist
2. Usually done under local anaesthesia with sedation, or occasionally general anaesthesia
3. Some procedures are performed using a small catheter (thin tube) that is inserted into a blood vessel (commonly through the wrist or groin) under X-ray guidance. This technique is usually required in complex arteriovenous malformations
4. Other procedures can be done by inserting a needle directly into the vascular malformation (venous and lymphatic malformations).
5. Special materials (such as sclerosing foam, bleomycin, doxycycline, medical glue or coils) are delivered to block abnormal blood flow. These are delivered through the catheter or the needle under X-ray guidance.
6. The procedure typically takes 1–3 hours depending on complexity.

Benefits

1. Minimally invasive – no large surgical incision
2. Targeted treatment of abnormal vessels
3. Can significantly reduce pain, swelling, and bleeding
4. Usually improves cosmetic appearance
5. Often performed as a day procedure or short hospital stay
6. Can be repeated or staged if required

Risks and side effects

Most patients recover well, but possible side effects include:

1. Mild pain or swelling in the treated area for several days
2. Bruising at the catheter/needle insertion site
3. Temporary skin discoloration or firmness
4. Inflammation of the treated area

Rare risks include:

1. Infection
2. Skin injury or ulceration
3. Non-target embolisation (affecting nearby normal tissue that wasn’t supposed to be treated)
4. Nerve irritation (depending on location)
5. Recurrence or need for further treatment

After the procedure

1. Most patients go home after a short day stay or short overnight stay. This depends on the complexity of the procedure.
2. Mild discomfort or swelling is common and usually settles within a few days.
3. Normal activities can often resume within a few days, depending on the treatment site.
4. Compression garments may be recommended in some cases.
5. Improvement in symptoms may occur gradually over weeks to months.
6. Some malformations require staged treatments for optimal results.
7. Follow-up imaging and clinic review will be arranged.

Talk to us

If you have a vascular malformation and are experiencing symptoms, talk to your interventional radiologist or referring doctor about whether sclerotherapy/embolisation is an appropriate treatment option for you.