Ask the Expert

Pediatric Vascular Malformation – Symptoms and Treatment

Robert F. Hanna, MD, is an Interventional Radiologist at Banner Desert Medical Center in Mesa, AZ.

Vascular malformations in children are not extremely common, occurring in every 1 to 2 in 10,000 children, which can make finding a physician who treats them a challenge for parents. Symptoms can be a noticeable deformity, such as a bulge in the neck or pain in an affected extremity, particularly during exercise.

Vascular malformations mainly come in three varieties:

  1. Arteries (arteriovenous malformation),
  2. Veins (venous malformations), or
  3. Lymphatics (lymphatic malformation). 

Vascular malformations are made up of clusters of these arteries, veins or lymphatics that form a ball, much like a tumor. They are not cancerous and do not spread but can grow large and cause the arms or legs to be deformed. They also can be quite painful.  

Treatment is usually sought when the malformation is causing pain, heart problems or is cosmetically unappealing. If the malformation is not bothering a child, then they do not have to be treated. Treatment often depends on what organs and nerves are close by, and therapy is tailored to each patient. The two main therapies are “sclerosis” and “ablation.”  Sclerosis means that you inject something irritating into the malformation, which causes it to scar and shrink. Ablation means to burn or freeze something. With malformations, we often use freezing (cryoablation) because it is less painful and safer for the patient. Treatments is typically an outpatient procedure, completed in 1-2 hours, and children can go home the same day.  

Many malformations require multiple treatments because the lining of a malformation is ”alive” and tries to grow back. It can take multiple therapies to try to get rid of them. The goal of therapy is symptom relief by destroying enough of the malformation to make the symptoms go away. The goal is not necessarily to destroy 100% of the malformation, which sometimes cannot be done because of important organs or blood vessels located close to it. If it comes back, repeat treatments can be performed.

Following treatment, the skin around the treatment site may be black and blue for 2-3 weeks.  Also, there may be some pain or muscle soreness, but it is usually minimal and goes away in 3 to 5 days. In virtually all cases, treatment leads to a significantly improved quality of life for children

If your child is diagnosed with a vascular malformation, seek out an Interventional Radiologist with expertise in pediatrics for evaluation and treatment options.

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