Vascular Malformations

Advances and Controversies in Contemporary Management

Byung Boong Lee, Peter Gloviczki, Francine Blei, Byung Boong Lee, Peter Gloviczki, Francine Blei

• Publisher: CRC Press
• Year: 2019
• ISBN:
  9781000731880
• Edition: 1
• Topic: Medicina
• Subtopic: Medicina chirurgica e chirurgia

This new book on vascular malformations brings together international experts to present advances and discuss controversies in the multidisciplinary management of patients with congenital vascular malformations.

Major advances in recent years in medical genetics, and tremendous progress in the fields of imaging and minimally invasive percutaneous interventions have revolutionized both evaluation and management of vascular malformations. The six major parts of this state of the art book ensure that the reader has the most up to date valuable clinical information to ensure the delivery of world class clinical practice. Beautifully illustrated with color line drawings, numerous photographs and informative tables, the advances and controversies of the full spectrum of vascular malformations are presented in 90 definitive chapters.

Vascular Malformations brings new information and unparalleled insights to vascular specialists and physicians, trainees and allied health professionals who participate in the care of patients with vascular malformations, either in a private practice setting or at a major institution in an interdisciplinary vascular center.

Part1

Congenital Vascular Malformations (CVMs) in General

Section 1Definition and Classification

Section 2Diagnosis

Section 3Management

Section1

Definition and Classification

1ISSVA classification: Controversy with the benefit and liability

Raul Mattassi

2Hamburg classification: Controversy with the benefit and liability

Peter Gloviczki and David J. Driscoll

3Syndromic classification of congenital vascular malformations: How useful is it?

Francine Blei

4Consensus on contemporary classification

Byung-Boong Lee and Leonel Villavicencio

1

ISSVA classification: Controversy with the benefit and liability

Raul Mattassi

The classification of vascular anomalies of the International Society for the Study of Vascular Anomalies (ISSVA) was approved by the general assembly of the society during the 19th meeting in 2014 in Melbourne, Australia, and updated and approved in 2018 during the general assembly of the society in 2018 in Amsterdam, the Netherlands. This classification is the result of a main job of the French pathologist Michel Wassef, who tried to create a structural basis in which all the different types of vascular anomalies could be included.1

The classification has a multilevel structure with a main first step (an overview), which includes all the types of defects and many subgroups in which all the known anomalies are included. One of the main advantages of this classification is the possibility to add different new forms without changing the main base, as this topic is quickly evolving due to active research in the field (Figure 1.1).

Figure 1.1 International Society for the Study of Vascular Anomalies classification, first overview table, last revision 2018. Available at www.issva.org—by clicking on the underlined links, additional tables open with all subgroups of vascular anomalies.

One of the main updates of the classification, approved in Amsterdam, was the inclusion in the classification of the new genetic data. This rapidly developing field requires a continuous update that is easily possible with such a flexible classification.

To switch over to the new classification from the older one, however, was not quickly achieved by many doctors, as some aspects of the new one were not immediately understood. Old, eponym-/syndrome-based classifications (Klippel–Trenaunay/Parkes Weber syndromes and others) and hemodynamic-/flow-based classifications (fast flow/low flow) remain to cause significant confusion and failed to make a clear distinction between types of malformations (e.g., arteriovenous [AV] malformation and AV fistula).

The most accepted former classification was the Hamburg one (Belov, 1989), which has the advantage of simplicity, only dividing the different types of anomalies in main groups, rendering simple and clear a field that was confusing in the past.2,3

The Hamburg classification was an a...