Vascular treatments

Congenital vascular defects are also referred to as vascular malformations, angiodysplasias, vascular abnormalities or, often incorrectly, as haemangiomas. These are congenital defects affecting the structure of the vascular system that can lead to pain, swelling and skin discolouration, but also to major haemorrhaging or organ damage.

These are very rare conditions, and their specific diagnosis and treatment outside southern Germany is performed by the Department for X-ray Diagnostics at University Hospital in Regensburg in close collaboration with the hospital's vascular surgery, plastic surgery, paediatrics and dermatology departments.

These vascular defects can occur on their own, but sometimes also occur in conjunction with other congenital malformation syndromes. Diagnosing these plays an important role in terms of both treatment and prognosis.

Please feel free to contact us if you have any major concerns about your condition, diagnosis or prognosis, or if you are unsure whether you may need treatment.

In principle, all blood vessels in all parts of the body can be affected by vascular malformations.

The following are particularly frequently affected:

• Central nervous system
• Veins, arteries and/or lymph vessels in the legs or arms
• Face and neck area

The combination of vascular malformations of different types of vessels (e.g. veins and arteries or lymph vessels) is often associated with macro- or microplasia of an affected limb. This combination is sometimes referred to as Klippel-Trenaunay syndrome.

Vascular defects not only present a wide range of symptoms, but also vary greatly in severity. The skin often shows only the ‘tip of the iceberg’.

Clinical and imaging diagnostics

Extensive, detailed and expert clinical and imaging diagnostics, as well as correct classification of vascular defects, are vital for successful treatment, especially in view of the sometimes invasive therapeutic measures involved.

This is the only way to ensure that therapeutic measures are applied appropriately and at the right time.

The treatment required for vascular defects depends on the type, extent and location of the condition. Many of these defects require invasive treatment, while others require open surgery.

Minor, uncomplicated errors can also be treated with sclerotherapy.

Major vascular defects are treated in certain circumstances with laser therapy or angiographic embolisation (closure of the vessel using a catheter).

A laser fibre is inserted directly into the vascular defect through the skin using a puncture needle, and the laser light is scattered in the tissue via a ‘light diffuser’, allowing the laser beam to penetrate a large area of tissue.

The aim is to cause a local inflammatory reaction and thrombus formation, which in the medium term leads to the obliteration of the treated tissue area.

Treatment is usually performed several times (two to five times) under local anaesthetic, but larger treatment sessions may also require treatment under general anaesthetic.

A very thin angiography catheter is inserted through the skin under local anaesthetic to locate the affected vessels, which are then closed using special medication. This can prevent further, sometimes life-threatening expansion of congenital short circuits between arteries and veins.

The difficulty with this form of therapy lies in the targeted closure of the many small vascular shunts themselves, as closure of only some of the feeding arteries is likely to result in a recurrence of the disease.

This therapy also usually requires several sessions to achieve definitive closure, with general anaesthesia only necessary in rare cases.