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Semin Plast Surg 2014; 28(02): 079-086
DOI: 10.1055/s-0034-1376264
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Medical Therapy for Pediatric Vascular Anomalies

Judith F. Margolin
1   Baylor College of Medicine, Texas Children's Cancer and Hematology Service, Houston, Texas
,
Heather Mills Soni
1   Baylor College of Medicine, Texas Children's Cancer and Hematology Service, Houston, Texas
,
Sheena Pimpalwar
2   Division of Interventional Radiology, Department of Radiology, TCH, Baylor College of Medicine, Houston, Texas
› Author Affiliations
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Publication History

Publication Date:
31 May 2014 (online)

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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.

Keywords

vascular anomalies - chemotherapy - sirolimus - kaposiform hemangioendothelioma - tufted angioma - blue rubber bleb nevus syndrome
 

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