Interventional Treatment Options in Children with Extracranial Vascular Malformations

Abstract

Extracranial vascular malformations vary greatly and belong to the complex field of orphan diseases and can involve all segments of the vascular tree: arteries, capillaries, and veins, and similarly the lymphatic system. The classification according to the International Society for the Study of Vascular Anomalies (ISSVA) represents an important guidance for selecting appropriate therapy. Although many of the principles of endovascular treatment, including image-guided sclerotherapy and embolization, are similar in adult and pediatric practice, there are some distinct differences regarding the treatment of vascular malformations of children. Thus, it is crucial to involve longer-term plan about managing these chronic diseases and their impact on a growing child. This review provides a detailed overview over the clinical presentation of venous, lymphatic, and arteriovenous malformations in children and emphasizes the specifics of their interventional treatment options, including distinct pediatric dose limitations and procedure-related side effects.

Zusammenfassung

Extrakranielle vaskuläre Malformationen sind sehr variabel und gehören zum komplexen Feld der seltenen Erkrankungen. Sie können alle Segmente des Gefäßbaumes betreffen: Arterien, Kapillaren und Venen, sowie das Lymphgefäßsystem. Die Klassifizierung nach der International Society for the Study of Vascular Anomalies (ISSVA) stellt eine wichtige Orientierungshilfe für die adäquate Therapie dar. Obwohl viele der Prinzipien hinsichtlich der interventionellen Behandlung, wie der bildgesteuerten Sklerotherapie und Embolisation, im Grundsatz ähnlich zu denen erwachsener Patienten sind, gibt es einige deutliche Unterschiede bei der Behandlung von vaskulären Malformationen bei Kindern. Von entscheidender Bedeutung ist, die Behandlung dieser chronischen Erkrankungen und ihre Auswirkungen auf das heranwachsende Kind längerfristig zu betrachten. Diese Übersicht gibt einen detaillierten Überblick über die klinische Präsentation venöser, lymphatischer und arteriovenöser Malformationen bei Kindern und hebt die Besonderheiten der interventionellen Behandlungsoptionen hervor, einschließlich der spezifischen pädiatrischen Dosisbegrenzungen und therapieassoziierter Nebenwirkungen.

Keywords

vascular malformation - pediatric intervention - endovascular treatment

Schlüsselwörter

Vaskuläre Malformationen - pädiatrische Intervention - interventionelle Behandlung

Publikationsverlauf

Eingereicht: 27. Oktober 2021

Angenommen: 23. Dezember 2021

Artikel online veröffentlicht:
09. März 2022

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