Chapter: Invasive therapy
Article: 9 of 15
Update: Feb 07, 2021
Author(s): Barbera, Letterio Christian
Open surgery usually consists of a resection of the congenital vascular malformation and is therefore primarily an ablative procedure. Only in exceptional cases is it possible to correct or reconstruct the immature vessels morphologically and functionally using vascular surgery techniques.
Thus, open surgery should be used when other conservative and invasive therapeutic methods are not applicable or have not been successful. This does not diminish the importance of surgical therapy, but underlines the necessity for careful consideration of the indication and an interdisciplinary therapeutic approach.
The choice of the appropriate treatment can thus be made when, on the one hand, the clinical picture is well known and, on the other hand, when the entire spectrum of possible procedures is known and available.
Interdisciplinary case discussions, similar to tumor conferences, provide a suitable framework for establishing a differentiated therapy strategy. Pediatrics, pediatric surgery, interventional radiology, plastic surgery, vascular surgery, ENT, OMF, dermatology, physiotherapy and orthopedics should ideally be represented. The interdisciplinary evaluation of each case is based on numerous factors, such as type of malformation (AVM, VM, LM), patient history, symptoms, size and localization. Treatment wishes and social aspects such as family structure and place of residence are further considerations, especially when several treatments are necessary.