Classification ofvascular anomalies

and its implication on therapies

LINC 2018

Leipzig, Germany, 30. Jan 2018

Walter A. Wohlgemuth

University Clinic and Policlinic of Radiology

Martin-Luther University Halle-Wittenberg, Germany

Conflicts of interest

Scientific grants:Siemens, Phillips, ab medica, ev3/covidien/medtronic, itm Flowmedical, Toshiba, Cook, W. L. Gore

Lectures: ev3/covidien/medtronic, Biotronic, St Jude Medical, Abbott, Siemens, ab medica, Boston Scientific, itm Flowmedical, Terumo, W. L. Gore

Consulting:1st WITiG, itm Flowmedical, Siemens, ev3/covidien/medtronic, ab medica

Proctoring:W. L. Gore, ev3/covidien/medtronic, ab medica

ISSVA Classification 2014

Vascular Anomalies

Vascular Tumors Vascular Malformations

- Benign- Locally aggressive /

borderline- Malignant

Simple Combined"Associated withother anomalies"

Venous MLymphatic MCapillary M

CVMCLMCAVM

Klippel-TrenaunayParkes-WeberSturge-Weber

AVMAV Fistula

LVMCLVM

CLOVESProteus etc.

Wassef M, et al. Vascular Anomalies Classification: Recommendations From the International Society for the Study of Vascular Anomalies. Pediatrics 2015; 136: e203-214

Simpler …….

Vascular Anomalies

Vascular Tumors Vascular Malformations

Simple Combined Associated withother anomalies

One type ofvessel

Different involved vessels

+ / -soft tissue / bone

Fast-FlowLesions

Arteriovenous Malformation (AVM)

Embolisationtransarterial, direct,

transvenous

Resection of the occludednidus

Arteriovenous Fistula (AVF) Embolisation

Slow-FlowLesions

Venous Malformation (VM)

Sclerotherapy

Lasertherapy

Resection

Lymphatic Malformation (LM)

Sclerotherapy(macrocystic forms)

Resection, Lasertherapy

mTOR inhibitors (?)

Capillary Malformation (CM) Lasertherapy

Invasive therapy according to classification

Wohlgemuth WA, Meyer L, Sadick M. Gefäßanomalien: Eine interdisziplinäre Herausforderung. Dtsch Arztebl 2017;114:51-52

Vascular Anomalies

• Vascular tumor Vascular malformation

• Fast-flow Slow-flow malformation

– Fast-flow: AVM Embolisation (transcatheter)

– Slow-flow: VM, LM Sclerotherapy (direct puncture)

• Diagnosis: Clinic > Ultrasound > MRI

Univ.-Prof. Dr. Dr. Walter A. Wohlgemuth1) University Clinic and Policlinic of Radiology, Martin-Luther University Halle-Wittenberg, Germany

2) German Interdisciplinary Society of Vascular Anomalies

Thank you for your attention!

Classification ofvascular anomalies

and its implication on therapies

LINC 2018

Leipzig, Germany, 30. Jan 2018

Walter A. Wohlgemuth

University Clinic and Policlinic of Radiology

Martin-Luther University Halle-Wittenberg, Germany