Special considerations in vascular anomalies: operative management of upper extremity lesions

The past 3 decades has seen a steady, almost exponential, increase in knowledge of vascular anomalies. A useful biologic classification system has evolved. A careful physical examination augmented with refined imaging will yield an accurate diagnosis and set the stage for treatment. A multidisciplinary team can offer treatment options with some degree of predictability. One option is surgery, which can be fraught with numerous complications. This article focuses on surgical principles and technical pearls in the treatment of these unique problems involving the upper limb. If incorporated into routine management, these suggestions will improve surgical outcomes.