ABSTRACT

This chapter deals with the diagnosis and management of low-flow vascular malformations (LFVMs) that are considered to be predominantly venous. Data from this study showed that all LFVMs showed CD31-positive immunostaining of endothelial cells and negative GLUT-1 staining. As numerous particulars can interfere with the observations, distinguishing between high-flow vascular malformations and LFVMs using magnetic resonance imaging can be challenging in some more complex cases. In a subsequent study, we also analyzed the morphology of LFVMs to identify the lesion characteristics that affect the outcomes of treatment. Data from our analysis demonstrated that symptomatic, diffuse, extensive LFVMs and LFVMs that involve multiple tissue planes and vital structures are best treated with foam sclerotherapy. Primary surgical resection is also the treatment of choice for localized, microcystic, and superficial LFVMs. Patients with symptomatic venous malformations are best treated with foam sclerotherapy and/or primary surgical resection, dependent upon the lesion’s location, extent, and morphologic characteristics.