Vascular Malformation & Hemangioma

Vascular malformations are abnormal vessel structures that form during development. They are also known as “vascular tangles”. Depending on the vessel type they are classified as capillary, venous, lymphatic or arterial (arteriovenous) malformations. Hemangiomas are benign tumors caused by proliferation of vascular cells and are usually noticed in infancy.

Malformations grow with the child and can become more noticeable with hormonal changes, trauma or pregnancy. Hemangiomas often grow for a while and then shrink on their own; the need for treatment depends on their location and the problem they cause.

Blue, purple or red discoloration of the skin, swelling, a soft palpable mass, pain, a sense of heaviness, increased warmth, bleeding, ulceration or enlargement of an arm or leg can occur. Lesions of the face and neck can affect appearance and function. Large arteriovenous malformations can place a load on the heart.

Diagnosis is made by examination, color Doppler ultrasound and usually MRI. MRI is the most useful method to show the type of lesion and its relationship to surrounding tissues. The treatment plan depends on the type and location of the lesion, so correct classification is very important.

Two methods are used most often. In sclerotherapy a medicine (sclerosing agent) is injected into the malformation with a needle under imaging; it damages the inner surface of the abnormal vessel so it closes. In embolization a catheter is advanced to the vessel feeding the lesion and the vessel is closed with a special liquid, particles, coils or plugs. The goal is to shrink the abnormal vessels without harming the surrounding healthy tissue.

In some patients treatment is not completed in a single session; several sessions at intervals may be needed. It can be planned together with surgery, laser or drug therapy, using a multidisciplinary approach.

Publications in which the doctor is among the authors include a single-center experience on percutaneous management of peripheral vascular malformations (2011) and embolization of high-flow craniofacial vascular malformations with Onyx (2007). Treatment of vascular tangles is also explained in a video on the Press & Media page.

After the procedure swelling, pain or bruising may occur; these usually respond to painkillers and cold packs. Compression stockings are recommended in some patients. Shrinkage of the lesion can take weeks to months; follow-up is planned with examination and imaging.

Risks include pain, swelling, skin involvement, nerve injury, rarely clots and lack of response to treatment. The risk varies with the location and type of the lesion.

If you notice a vascular lesion that has been present since birth or is growing, changing color, painful, bleeding or ulcerating, especially in functionally important regions such as the face, neck, tongue, around the eye or the hand and foot, assessment is recommended. Rapidly growing red marks in babies should be shown to a specialist early.

Correct diagnosis and classification directly affect treatment success. The lesion is therefore assessed in detail with MRI and, when needed, angiography before treatment starts.

At the first consultation your complaints, medical history, medications (especially blood thinners and diabetes drugs), allergies and previous imaging and test results are reviewed together. How long the lesion has been present, its growth rate, whether there is pain or bleeding and its relationship to growth in children are asked about. Please bring previous reports, films and CDs, your current medication list and any blood test results.

If needed, additional imaging or tests are requested. Whether the treatment is suitable, how the procedure will be done, the possible risks and the alternatives are explained in detail; your questions are answered and the procedure is planned after your consent is obtained.

Preparation instructions are given according to the type of procedure and the patient's condition. In general this involves fasting for a set time before the procedure, having tests that show kidney function and bleeding-clotting values and adjusting some medications as advised by the doctor. Always tell us if you are allergic to contrast material or medicines.

Having a relative with you on the day of the procedure is helpful for returning home after discharge.

Consultations and procedures are carried out in person at Ankara City Hospital, Neuro-orthopedics Building, Department of Radiology, Interventional Radiology Unit; online consultation is not offered. Appointments can be made on DoktorTakvimi via the Book button or by phone at 0850 333 0388. See the Contact page for the address and directions.