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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Management of Venous Malformations
Julien Coulie1, Emmanuel Seront2, Miikka Vikkula3
1Division of Plastic Surgery & Multidisciplinary Center for Vscular Anomalies, Cliniques universitaires Saint Luc, UCLouvain, Brussels, Belgium; Human Molecular Genetics, de Duve Institute, UCLouvain, Brussels, Belgium.
Abstract:
Venous malformations (VMs) are slow-flow vascular anomalies arising from hyperactivation of the TIE2-PI3K-AKT-mTOR pathway. This comprehensive review delineates the diverse clinical landscape of VMs, ranging from sporadic lesions to complex hereditary and syndromic phenotypes. We compile clinical characteristics of all VM subtypes. We detail diagnostic protocols and assessment for localized intravascular coagulopathy. Management requires a multidisciplinary approach, integrating conservative measures, sclerotherapy, surgery, and targeted medical therapies to optimize symptomatic relief and patient quality of life. We propose a treatment algorithm based on VM subtypes and affected tissue as well as different treatment combinations for staged management of complex cases.
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