Emangiomi e malformazioni vascolari

Congenital vascular malformations represent a heterogeneous group of isolated or multiple abnormalities, sometimes associated with complex congenital syndromes. They rarely occur in the daily practice of vascular surgeons, are often misdiagnosed and, for the most part, left untreated. The current classification recognizes two distinct groups of lesions, hemangiomas and vascular malformations. Hemangiomas are not present at birth, proliferate in the first year of life and then involute with complete resolution in over 50% of children by the 6th-8th year of life; a therapeutic intervention (mainly corticosteroids or interferon-alfa 2a) is required only for life-threatening hemangiomas. Vascular malformations are always present at birth, grow along with the child, and never involute. Surgery and/or sclerotherapy are indicated for low-flow malformations (venous and/or lymphatic forms), whereas embolization followed by surgery is the first- choice procedure for arteriovenous malformations. Laser therapy is ideal for cutaneous capillary malformations (portwine stains). Knowledege of classification and evolution of congenital vascular lesions is essential for planning the most appropriate treatment.