[Management of venous malformations: A prospective study of 33 cases]

Determine the epidemiology and frequency of complications, and compare the efficacy of different therapeutic approaches.

This prospective study included patients with venous malformation (VM) treated at the Vascular Anomalies Center between 2019 and 2023.

Thirty-three patients were included in this study. The median age of the patients was 20 years, 17 patients were born with VM. 63% had symptomatic VM. The most common location was the face (42%). Aesthetic impact was significant in patients under 12 years old (P=0.01) and in the cephalic extremity (P=0.000). Treatment was initiated only in cases of symptomatic VM or with aesthetic impact. Compression garments were used in 6 patients, sclerotherapy in 14 patients, including 2 after surgery, and surgery in 16 patients, including 5 after non-successful sclerotherapy. Two patients received curative Low molecular weight heparin (LMWH) injection. Sirolimus was prescribed to 4 patients. These treatments resulted in complete regression in 10 patients and partial improvement in 12, with failure or recurrence in 7.

Most patients present with symptomatic VM with a functional or aesthetic impact. This study underlines the difficulty of managing VM, which must be adapted on a case-by-case basis, and confirms that medical and contention treatments can only bring about an often-transient improvement in symptoms. Only complete surgical excision can provide definitive cure.