Surgical Considerations in Vascular Malformations

Vascular malformations are generally congenital benign lesions that have multiple variations in treatment algorithms. Surgery can be used as a single modality or as an adjunct in multimodal therapy to treat these lesions. Here we discuss surgical treatment of the major vascular malformations, including lymphatic, venous, and arteriovenous malformations. We explain some of the basic principles to resection of simple and complex lesions and adjunctive therapies. These adjunct therapies include chemotherapeutic injections, embolization, and laser therapy. Surgical resection of complex lesions should only be performed by an experienced vascular anomalies surgeon. A team approach is generally necessary to provide safe and effective treatment. While surgery for these complex lesions is an option, the most important principle to adhere to when treating any of these lesions is that the treatment should be no worse than the disease.