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