Phlebological seminar "Venous dysplasias and malformations", "MIFC", Moscow, 03.06.2021.
Sergei Viktorovich Sapelkin, vascular surgeon, phlebologist, professor, N.N. A.V. Vishnevsky ”, (Moscow), in the conference hall of the Moscow Innovative Phlebological Center gave a very interesting lecture on the topic:“ Venous dysplasias and malformations ”.
Vascular surgeon, phlebologist, professor Sapelkin Sergey Viktorovich
Venous malformations and dysplasias - determination of general anomalies in the development of the venous system that form at various stages of embryogenesis. Sergei Viktorovich considered, within the framework of the lecture, an approach to pure venous dysplasias without an arterial component. Venous malformations affect a wide variety of anatomical areas. Allocate venous malformations of the head, neck, extremities. These localizations are characteristic of abnormalities in the angiogenesis process in the early stages with a high tendency to recurrence.
Phlebologists A.E. Koreshkov and Voloshkin A.N. listen to a lecture by S.V. Sapelkin
Trunk venous malformations are due to a defect in the late stages of embryogenesis and are less prone to relapse after treatment.
Diagnosis of venous malformations and angiodysplasias
Localization of venous malformations
The basis for the diagnosis of venous malformations and angiodysplasias are:
- Clinical investigation (history taking, examination, palpation)
- Ultrasonic duplex scanning
- Magnetic resonance phlebography (without contrast)
- Computed tomography with contrast.
An important diagnostic, but not a mandatory sign of venous dysplasia, may be visualization of phlebolitis by ultrasound. Increased requirements are imposed on the diagnosis of venous malformations and angiodysplasias. In addition to a fine assessment of the topographic and anatomical relationships of various structures, it is necessary to exclude the arterial component of dysplasia.
Treatment of venous malformations and angiodysplasias
Therapeutic tactics for venous malformations
In the overwhelming majority of clinical cases, Sergey Viktorovich noted the need to use mini-invasive technologies in the treatment of venous malformations and angiodysplasias:
- Endovasal thermal bleeding (radio frequency and laser)
- Percutaneous laser coagulation.
At the same time, Professor Sapelkin noted some features of the approach to the treatment of venous malformations and angiodysplasias. In addition to good technical equipment, a team, interdisciplinary approach is required. Often, the expert opinion of the following specialists is required: a traumatologist, a plastic surgeon, an ophthalmologist, a neurosurgeon, and even a specialist in purulent surgery. The active use of minimally invasive technologies should be combined with the use of technologies and interventions from related specialties.
Laser coagulation for venous malformations
And most importantly, it is necessary to make medical care for patients with venous dysplasia more accessible to patients, to expand the area of medical institutions capable of providing high-quality medical care to such patients.