Vascular lesions are a group of blood vessels disorders that can be congenital (present at birth but may appear after birth) or acquired. They may be cutaneous or in organs. Plastic surgeons deal with skin vascular lesions.

SYMPTOMS

Skin vascular lesions can be of capillary, arterial, venous, lymphatic or combined origin. Patients mostly have cosmetic issues. They may present with complications like ulceration, pain, bleeding, discharge, visible disfigurement or obstruction of vision and ear canal.

 

PROCEDURE

• Surgery

Surgical excision is done under general anesthesia to either remove the primary lesion or to get rid of residual scars after other treatments.

• Injection

Steroids steroids (triamcinolone) are injected in the lesion by small needles. Multiple sessions may be needed at one month intervals.

3 % Sodium tetradecyl sulfate is a sclerosing agent.it is injected in

Large deep Vascular malformations

• Ethanol  (alcohol) can be injected as sclerosing agent into the lesion to reduce the size of lesion

• Bleomycin  is an antibiotic that may be injected into certain vascular malformations to make them shrink.

• Others (doxycycline, OK-432.)

• Laser

Pulse dye laser, ND-YAG and Argon laser are effective in treatment of small cutaneous vascular lesions. Light is absorbed by red hemoglobin and destroys the blood vessels in the lesion. It has minimal damage to the surrounding tissues.

• Cautery 

Electrocautery can be used to treat superficial vascular lesions on the face. It’s less invasive and used in small lesions.

 

FREQUENTLY ASKED QUESTIONS

1.What causes a vascular lesion?

Some lesions are genetic while others have unknown causes.

2. Is laser the treatment of choice for all vascular lesions?

Laser addresses only small cutaneous lesions (mostly capillary origin). It can also reduce residual lesions after surgery. Large high flow lesions cannot be treated with laser alone.

3. Are there any chances of recurrence of the lesion after treatment?

there is always a chance of recurrence of lesion after any treatment modality. Complete excision of lesions is difficult.

4. Is there a chance of tumor formation in these lesions if I will not get any treatment?

yes, there is a very rare chance of malignant transformation of vascular lesions.

5. What are the complications of surgery?

surgery of vascular lesions may have complications like bleeding, scarring, infection, disfigurement and recurrence. Surgical excision of arterial malformation is planned after embolization (temporary blocking) of the feeding vessel to prevent bleeding.

 

Written by :  Dr. Yusra Afzal
Copyrights: Pakistan association of Plastic Surgeons