SIR 2024
Embolization
Sophia M. Durney, BS (she/her/hers)
Medical Student
Kaiser Permanente Bernard J Tyson School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Kavenpreet Bal, MS
Medical Student
Kaiser Permanente Bernard J. Tyson School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Alok Bhatt, MD
Assistant Program Director of Vascular and Interventional Integrated Residency
Kaiser Permanente physician
Financial relationships: Full list of relationships is listed on the CME information page.
To provide an overview of diagnostic criteria and types of vascular malformations, including capillary, lymphatic, venous, and arteriovenous malformations. To review non-interventional (surgical, medical, laser) options for congenital vascular malformations and pharmacotherapies (beta-blockers, limus drugs, and chemotherapy). To explore the efficacy and complications of these pharmacotherapies in combination and as adjunctive therapy with non-interventional treatments. This exhibit will: Provide an overview of types of congenital vascular malformations. Review non-interventional options used in the treatment of congenital vascular malformations (medical, laser, and surgery). Review medications used to treat vascular anomalies including beta-blockers, sirolimus, and combination chemotherapies (vincristine/glucocorticoids). Review the indications, efficacies, and side effects of each medical management strategy. Describe the role of post-surgical adjunctive therapies in vascular malformations including capillary, macrocytic lymphatic, venous, and arteriovenous malformations.
Background: Vascular anomalies comprise a variety of malformations and tumors, which can be differentiated based on endothelial proliferation {1}. Vascular tumors exhibit significant endothelial division, so they are responsive to beta-blockers, limus drugs, and chemotherapy {1}. However, management of vascular malformations is transitioning from traditional resection, embolization, sclerotherapy, and laser to combinations with pharmacotherapy {2}. It is valuable to understand the efficacy of drug treatments and combinations in management of vascular anomalies. Vascular anomalies require a rigorous diagnostic process to ensure appropriate therapy is used, and patients may require interdisciplinary management. We will provide an overview of diagnostic methods for vascular malformations including tissue biopsy and imaging, and explain the indications, efficacies, and complications of medications used to treat vascular anomalies.
Clinical Findings/Procedure Details:
Conclusion and/or Teaching Points: It is critical to identify effective adjunctive therapies for vascular anomalies because traditional surgical methods often control but do not cure disease, and pharmacotherapies may provide improved outcomes when used in conjunction with other treatments. A subset of patients may benefit from non-interventional options like laser therapy, and it is valuable to explore the efficacy of these treatments in patients with complex vascular malformations {3}.