Vascular malformations

Who it may help

Treatment may suit you if you:

• have a diagnosed vascular malformation that causes symptoms
• have pain, swelling or repeated bleeding
• have a lesion that is growing or becoming more troublesome
• want to avoid or reduce surgery
• are looking for a minimally invasive option

Conditions treated

• Vascular malformations (venous, lymphatic or arteriovenous) causing pain or swelling
• Vascular lesions that bleed or have ulcerated
• Vascular malformations that affect appearance or function

Understanding vascular malformations

Vascular malformations, sometimes called birthmarks, are abnormal bundles of blood vessels that are present from birth. They can involve blood vessels of any size, both veins and arteries, as well as lymph vessels, and can occur anywhere in the body, including the skin, face, arms or legs.

Some vascular malformations, called arteriovenous malformations (AVMs), have direct connections between arteries and veins without the normal network of tiny capillaries in between. This can increase blood flow and pressure in the affected area. Some malformations are very complex and may need several treatment sessions.

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

• pain or discomfort
• swelling or a visible lump
• skin discolouration or warmth
• bleeding
• problems with function, such as difficulty moving, or concerns about appearance

Sclerotherapy or embolisation is a minimally invasive, image-guided treatment that reduces or blocks the abnormal blood flow in these lesions.

How the procedure is performed

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

Benefits

• No large surgical incision
• Treatment targeted at the abnormal vessels
• Can reduce pain, swelling and bleeding
• Often improves appearance
• Often done as a day procedure or with a short hospital stay
• Can be repeated or done in stages if needed

After the procedure

• Most people go home the same day or after a short overnight stay, depending on how complex the procedure was.
• Mild discomfort or swelling is common and usually settles within a few days.
• Normal activities can often resume within a few days, depending on the treatment site.
• Compression garments may be recommended in some cases.
• Symptoms may improve gradually over weeks to months.
• Some malformations need treatment in stages to get the best result.
• Follow-up imaging and a clinic review will be arranged.