Prognosis — Venous malformation

Venous malformations can affect personal development and quality of life. Fortunately, life-threatening situations occur extremely rarely. The prognosis of a congenital venous malformation varies considerably because of the very individual degree of severity. In addition to the baseline findings, influencing factors to be considered are the patient’s idiosyncrasy, personality structure, environment and treatment strategy.

In principle, the more extensive the total volume of the immature vessels is, the more relevant the symptoms of the disease will be. Localization also plays a significant role. Large venous malformations on the face, hands and feet can make life difficult for the affected person in the long term.

Structurally, the volume of a venous malformation usually increases during the course of life as blood filling increases. It is important to recognize and predict this momentum although it is difficult to quantify. As a result of the hydrostatic pressure, this is more pronounced on the lower extremity than on the upper extremity. A real proliferation of the lesion may occur. Thus, pain and functional deficits, which are still mild in a child or adolescent, can increase over the years if adequate therapy is not provided. Damage to the skin and the musculoskeletal system also becomes more pronounced in older age. The personality structure plays a very decisive role in how the disease is being experienced and processed. This can influence the prognosis favorably or unfavorably. A positive, life-affirming attitude will mentally strengthen the affected individual and help them exercise intensively, participate actively in life and enjoy a fulfilling social life. As with all other diseases, how an individual copes with the symptoms will depend on that person’s character. Early childhood experiences and thus the family environment play a decisive role. Overanxious parents, changing caregivers and experiences of grief, as well as frustrating or even harmful therapeutic attempts will weaken the child’s resilience. In adolescence, friends and teachers are important caregivers who can provide decisive support for the personal development of the affected child. In this context, the doctor has a leading role to play: she or he records the extent of the vascular malformation, educates the patient and the people surrounding the patient and provides practical advice for everyday life. The prognosis is better if this is done earlier and in more detail.

Irrespective of whether pain, functional limitations, coagulation disorders or esthetic aspects are the primary concern, their early detection, appropriate treatment and self-therapy make a favorable prognosis possible. The venous malformation will not be eliminated by this, but the affected person will be able to lead a life with few complaints.