This is a short film explaining what we do.
Vascular malformations are a complex group of developmental abnormalities that present significant challenges in diagnosis and management. The clinical presentation can range from an asymptomatic birthmark to fulminant cardiac failure. The diverse nature of symptoms associated with vascular malformations and their rarity (1 in 7000 births), means that patients have often seen multiple specialists before the correct diagnosis is made. The management of this complex group of patients should therefore be undertaken within a multidisciplinary team. Traditional treatments have been centered on surgical resection with the associated morbidity and predictable recurrences. Over recent decades it has become clear that there is no cure for the vast majority of vascular anomalies and treatment is aimed at symptom relief and preservation of function. Minimal invasive therapies have come to the forefront and Interventional Radiology has become central to the management of these conditions.
The exact make-up of the multidisciplinary team depends on the availability and interest locally, however it is clear that interventional radiologists form the core group of specialists that provide clinical assessment, imaging and treatment of the vast majority of patients with vascular anomalies.
In 1982 Glowacki and Mulliken proposed a “biological” classification of vascular anomalies based on clinical behaviour, histology and histochemistry. The classification was accepted by the International Society for the Study of Vascular Anomalies (ISSVA) and was updated at the inaugural ISSVA meeting in 1992. This classification is now widely accepted, and has help resolve the confusion of terminology in the field of vascular anomalies. The classification was updated at the 20th ISSVA workshop in Melbourne April 2014. There is substantial literature available for the investigation and treatment of vascular malformations, however the majority of the articles are observational without validated consistent outcome data to allow comparison between deferent agents and articles. There are no randomised control trials centred on patient outcomes and the treatment of these conditions. The exact pathophysiology and treatment algorithms are in their infancy and need further collaboration and study.
In April 2014 a group of interested interventional radiologists (IRs) involved in the study and management of vascular anomalies organised their first UK Vascular Anomalies Consensus Group meeting in Birmingham. This group was designed to bring interested IRs together to act as a forum for discussion, mentoring and education regarding vascular anomalies. The group discussed the issues required to obtain validated data to allow audit & research, diagnostic and follow-up imaging to improve patient outcomes and allow identification of the correct agents / management to employ. The aim is to invite other interested parties to participate in the group who have a significant vascular anomalies practice e.g. plastic surgeons, vascular surgeons and dermatologists.