Venous malformations of the hand: surgical treatment

Raul Ettore MATTASSI, MD1; Piero Di GIUSEPPE, MD2; 1Director, Specialist in Vascular Surgery; 2Hand surgeon, Specialist in Plastic Surgery; Center for Vascular Malformations “Stefan Belov”, Humanitas “Mater Domini” Hospital, Castellanza (Varese), Italy Abstract Congenital vascular malformations (CVM) of the hand are extremely variable and difficult to treat. The correct approach first requires a complete, stepwise diagnostic procedure from clinical examination to echo Doppler (ECD) examination followed by magnetic resonance (MR) imaging, which can be performed without contrast if ECD demonstrated a slow-flow malformation. Treatment can be performed via sclerosis or surgery. Sclerosis has the advantage of being less invasive but…

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Iliac vein compression: undervalued or overestimated?

Marc Emmanuel VUYLSTEKE, MD, PhD Vascular Surgeon & Head of Surgical Department, Sint-Andriesziekenhuis, Tielt, Belgium; Visiting professor, Department of Cardiovascular Science, University of Leuven, Belgium Abstract Iliac vein compression (IVC) is a common anatomic disorder affecting more than 20% of the adult population, especially young females. Most of those patients are asymptomatic. Some of them will develop symptoms in their left leg, such as swelling, pain, and heaviness. But progression to venous claudication, skin changes, and even venous ulceration is possible. Intolerance to exercise is an undervalued symptom. The most feared complication is the development of a deep venous thrombosis…

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Venous embryology: the key to understanding anomalous venous conditions

Byung-Boong LEE Professor of Surgery and Director, Center for Lymphedema and Vascular Malformations, George Washington University School of Medicine, Washington DC, USA ABSTRACT Venous embryology can explain many of the defects resulting in venous anomalies in later life, yet is often overlooked. Venous malformations are vascular malformations that only affect the venous system. They are classified into two different types depending on the embryological stage when the defective development occurs. Venous malformations originating during the early stage of embryogenesis are termed extratruncular, while those originating during the late stage of embryogenesis are classified as truncular. A defect at any point…

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Current management of visceral venous aneurysms

Athanasios D. GIANNOUKAS Giorgos S. SFYROERAS Department of Vascular Surgery, University Hospital of Larissa, University of Thessaly Medical School, Larissa, Greece ABSTRACT Visceral venous aneurysms are considered rare clinical entities with not variable pathogenesis, clinical presentation, natural history, and management. In an electronic search of the pertinent English and French literature, ninety-three reports were identified, including 176 patients with 198 visceral venous aneurysms. Patients’ ages ranged from 0 to 87 years, and there was no apparent male/female preponderance. The commonest location was the portal venous system (87 of 93 reports, 170 of 176 patients, 191 of 198 aneurysms). Portal system…

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