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Factors associated with thrombotic complications in pediatric patients with vascular malformations

Pablo Sepúlveda1, Alejandro Zavala2, Pamela Zúñiga3

  • 1Pontificia Universidad Católica de, Chile.

Journal of Pediatric Surgery
|November 26, 2016
PubMed

Insights

Children with vascular malformations face a higher risk of thrombosis. Larger malformation size, palpable phleboliths, and older age are key risk factors for these dangerous thrombotic events.

Area of Science:

  • Pediatric Hematology
  • Vascular Anomalies
  • Thrombosis Research

Background:

  • Thrombosis is an uncommon but serious complication in children with slow-flow vascular malformations.
  • Thrombotic events can lead to pain, recurrent episodes, and significantly reduced quality of life.
  • Severe outcomes like pulmonary thromboembolism and death have been reported in pediatric patients with vascular malformations.

Purpose of the Study:

  • To identify clinical and laboratory risk factors for thrombotic events in pediatric patients with vascular malformations.
  • To improve the understanding of thrombosis development in this vulnerable population.
  • To inform clinical management and risk stratification for children with vascular anomalies.

Main Methods:

  • A Case-Control study was conducted using clinical records from the vascular anomalies study group (VASG).
  • 46 pediatric patients with vascular malformations were assessed, with half experiencing thrombotic complications (cases) and half not (controls).
  • Multivariate logistic regression analysis was employed to determine significant risk factors for thrombosis.

Main Results:

  • Bivariate analysis revealed significant associations between increased D-dimer levels, larger surface area (≥10cm²), and palpable phleboliths with thrombotic complications.
  • Multivariate analysis identified older age, a surface area of the malformation ≥10cm², and palpable phleboliths as significant independent risk factors for thrombosis.
  • Palpable phleboliths showed a particularly strong association with thrombotic events (OR 85.29, p<0.01).

Conclusions:

  • Clinical factors such as the extent of the malformation, presence of palpable phleboliths, and older age are associated with an increased risk of thrombotic complications in children.
  • These findings highlight the importance of considering these clinical indicators for risk assessment in pediatric patients with vascular malformations.
  • Further research may focus on preventative strategies targeting these identified risk factors.
Abstract

Keywords:
ChildrenLocalized intravascular coagulationThrombosisThrombotic complicationsVascular malformations

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