RSS-Feed abonnieren
DOI: 10.1055/s-0034-1376264
Medical Therapy for Pediatric Vascular Anomalies
Publikationsverlauf
Publikationsdatum:
31. Mai 2014 (online)
![](https://www.thieme-connect.de/media/sps/201402/lookinside/thumbnails/10.1055-s-0034-1376264-1.jpg)
Abstract
Vascular anomalies (VAs) comprise a large variety of individual diagnoses that in different phases of treatment require a diverse number of medical specialists to provide optimal care. Medical therapies include agents usually associated with cancer chemotherapy, such as vincristine, as well more immunomodulatory types of drugs, such as glucocorticoids and sirolimus. These immunomodulating drugs are being successfully applied in cases that are typically categorized as vascular tumors, including kaposiform hemangioendothelioma (KHE) and tufted angioma (TA), as well as some of the more invasive types of vascular malformations (i.e., microcystic lymphatic malformations and blue rubber bleb nevus syndrome (BRBNS). These therapies need to be combined with good supportive care, which often involves anticoagulation, antimicrobial prophylaxis, and comprehensive pain and symptom-relief strategies, as well as appropriate drug monitoring and management of side effects of medical treatment. The optimal care of these patients frequently involves close collaboration between surgeons, interventional and conventional radiologists, medical subspecialists, and nurses.
-
References
- 1 Adams DM, Wentzel MS. The role of the hematologist/oncologist in the care of patients with vascular anomalies. Pediatr Clin North Am 2008; 55 (2) 339-355 , viii
- 2 Guevara CJ, Alomari AI. Interdisciplinary approach to treatment of vascular anomalies. Tech Vasc Interv Radiol 2013; 16 (1) 55-58
- 3 Enjolras O, Wassef M, Chapot R. Color Atlas of Vascular Tumors and Vascular Malformations. New York, NY: Cambridge University Press; 2007: 1-11
- 4 Kollipara R, Dinneen L, Rentas KE , et al. Current classification and terminology of pediatric vascular anomalies. AJR Am J Roentgenol 2013; 201 (5) 1124-1135
- 5 Tekes A, Koshy J, Kalayci TO , et al. SE Mitchell Vascular anomalies flow chart (SEMVAFC): A visual pathway combining clinical and imaging findings for classification of soft-tissue vascular anomalies. Clin Radiol 2014; 69 (5) 443-457
- 6 Hassanein AH, Mulliken JB, Fishman SJ, Greene AK. Evaluation of terminology for vascular anomalies in current literature. Plast Reconstr Surg 2011; 127 (1) 347-351
- 7 Soltani AM, Reinisch JF. Algorithmic approach to the management of hemangiomas. J Craniofac Surg 2011; 22: 585-588
- 8 Yang JY, Chan AK. Pediatric thrombophilia. Pediatr Clin North Am 2013; 60 (6) 1443-1462
- 9 Adams DM. Special considerations in vascular anomalies: hematologic management. Clin Plast Surg 2011; 38 (1) 153-160
- 10 Fernández Y, Bernabeu-Wittel M, García-Morillo JS. Kaposiform hemangioendothelioma. Eur J Intern Med 2009; 20 (2) 106-113
- 11 Croteau SE, Liang MG, Kozakewich HP , et al. Kaposiform hemangioendothelioma: atypical features and risks of Kasabach-Merritt phenomenon in 107 referrals. J Pediatr 2013; 162 (1) 142-147
- 12 Vetter-Kauczok CS, Ströbel P, Bröcker EB, Becker JC. Kaposiform hemangioendothelioma with distant lymphangiomatosis without an association to Kasabach-Merritt-Syndrome in a female adult!. Vasc Health Risk Manag 2008; 4 (1) 263-266
- 13 Blatt J, Stavas J, Moats-Staats B, Woosley J, Morrell DS. Treatment of childhood kaposiform hemangioendothelioma with sirolimus. Pediatr Blood Cancer 2010; 55 (7) 1396-1398
- 14 Hammill AM, Wentzel M, Gupta A , et al. Sirolimus for the treatment of complicated vascular anomalies in children. Pediatr Blood Cancer 2011; 57 (6) 1018-1024
- 15 Vignot S, Faivre S, Aguirre D, Raymond E. mTOR-targeted therapy of cancer with rapamycin derivatives. Ann Oncol 2005; 16 (4) 525-537
- 16 Starkey E, Shahidullah H. Propranolol for infantile haemangiomas: a review. Arch Dis Child 2011; 96 (9) 890-893
- 17 Tlougan BE, Lee MT, Drolet BA, Frieden IJ, Adams DM, Garzon MC. Medical management of tumors associated with Kasabach-Merritt phenomenon: an expert survey. J Pediatr Hematol Oncol 2013; 35 (8) 618-622
- 18 Chiu YE, Drolet BA, Blei F , et al. Variable response to propranolol treatment of kaposiform hemangioendothelioma, tufted angioma, and Kasabach-Merritt phenomenon. Pediatr Blood Cancer 2012; 59 (5) 934-938
- 19 Wang Z, Li K, Dong K, Xio XDOI, Zheng S. Letter to the Editor concerning ref 18 above. Pediatr Blood Cancer 2014;
- 20 Fernandez-Pineda I, Lopez-Gutierrez JC, Chocarro G, Bernabeu-Wittel J, Ramirez-Villar GL. Long-term outcome of vincristine-aspirin-ticlopidine (VAT) therapy for vascular tumors associated with Kasabach-Merritt phenomenon. Pediatr Blood Cancer 2013; 60 (9) 1478-1481
- 21 Blei F. Medical management of vascular anomalies. Facial Plast Surg 2012; 28 (6) 575-583
- 22 Ganesh R, Reddy M, Janakiraman L, Sathiyasekaran M. Blue rubber bleb nevus syndrome. Indian J Pediatr 2014; 81 (3) 317-318
- 23 Choi KK, Kim JY, Kim MJ , et al. Radical resection of intestinal blue rubber bleb nevus syndrome. J Korean Surg Soc 2012; 83 (5) 316-320
- 24 Krishnappa A, Padmini J. Blue rubber bleb nevus syndrome. Indian J Pathol Microbiol 2010; 53 (1) 168-170
- 25 McCarthy JC, Goldberg MJ, Zimbler S. Orthopaedic dysfunction in the blue rubber-bleb nevus syndrome. J Bone Joint Surg Am 1982; 64 (2) 280-283
- 26 Yuksekkaya H, Ozbek O, Keser M, Toy H. Blue rubber bleb nevus syndrome: successful treatment with sirolimus. Pediatrics 2012; 129 (4) e1080-e1084
- 27 Iacobas I, Burrows PE, Adams DM, Sutton VR, Hollier LH, Chintagumpala MM. Oral rapamycin in the treatment of patients with hamartoma syndromes and PTEN mutation. Pediatr Blood Cancer 2011; 57 (2) 321-323
- 28 Iacobas I, Burrows PE, Role of PTEN in vascular organization and anomalies. In: Xu K. , ed. PTEN: Structure, Mechanism of Action, Role in Cell Signaling, and Regulation; New York, NY: Nova Science Publishers; 2013: 211-233
- 29 Venkatramani R, Ma NS, Pitukcheewanont P, Malogolowkin MH, Mascarenhas L. Gorham's disease and diffuse lymphangiomatosis in children and adolescents. Pediatr Blood Cancer 2011; 56 (4) 667-670
- 30 Croteau SE, Kozakewich HP, Perez-Atayde AR , et al. Kaposiform lymphangiomatosis: a distinct aggressive lymphatic anomaly. J Pediatr 2014; 164 (2) 383-388
- 31 Safi F, Gupta A, Adams D, Anandan V, McCormack FX, Assaly R. Kaposiform lymphangiomatosis, a newly characterized vascular anomaly presenting with hemoptysis in an adult woman. Ann Am Thorac Soc 2014; 11 (1) 92-95
- 32 McClain KL, Kozinetz CA. A phase II trial using thalidomide for Langerhans cell histiocytosis. Pediatr Blood Cancer 2007; 48 (1) 44-49
- 33 Botero JP, Burs D, Thompson CA, Pruthi RK. Successful treatment with thalidomide of a patient with congenital Factor V deficiency and Factor V inhibitor with recurrent gastrointestinal bleeding from small bowel arteriovenous malformations. Haemophilia 2013; 9 (1) e59-e61PubMed
- 34 Blinc A, Golli T, Vodnik AC, Zver S. Concurrent thalidomide and radiation therapy for extensive arterio-venous malformations. Thromb Haemost 2008; 99 (1) 235-237