Single stage surgical excision for vascular malformation without any pre-operative adjuvant therapy: our experience regarding case selection in 20 patients


  • Narendra G. Naik Department of General Surgery, Rajiv Gandhi Medical College, Kalwa, Thane, Maharashtra, India
  • Sangram Karandikar Department of General Surgery, Terna Specialty Hospital and Research Centre, Navi Mumbai, Maharashtra, India



Laser in vascular malformation, MRI for vascular malformation, Sclerotherapy for vascular malformation, Surgery for vascular malformation


Background: Vascular malformations generally present in young population. The patients or their guardians seek treatment for alleviation of functional and/or cosmetic disfigurement. Non-invasive techniques with or without surgery are available, however surgical treatment has been found to be most definitive modality of treatment in selected cases of vascular malformations. In this article, we are presenting our experience of single stage partial/total excision of vascular malformation of various types, at different location on body without any adjuvant treatment with emphasis on the post-operative outcome. The aim of the study was to evaluate criteria for case selection, freedom from symptoms, cosmetic outcome, functional improvement, long term post-operative result and quality of life.

Methods: This study was performed to assess outcome of surgical treatment for 20 patients of vascular malformation. Fourteen were offered primary surgery and 6 out of 20 had received prior non-invasive treatment. The post-operative follow-up period was minimum 6 months and maximum for 4 years.

Results: The patients who underwent primary surgery were more satisfied than those who had received non-invasive treatment before surgery. This was because of satisfactory cosmetic outcome, minimal post-operative pain of short duration, no post-operative residual wound and minimal post-operative morbidity.

Conclusions: For treatment of vascular malformations, surgery can be offered as the primary and only treatment modality in selected cases because of immediate resolution of mass, minimal complications, satisfactory functional outcome and acceptable cosmetic appearance. Also, this improved patient compliance and long term follow up.


Şahin M, Yücel C, Kanber EM, İlal Mert FT, Bıçakhan B. Management of traumatic arterio-venous fistulas: A tertiary academic center experience. Ulus Travma Acil Cerrahi Derg. 2018;24(3):234-8.

Broeks IJ, Hermans DJ, Dassel AC, van der Vleuten CJ, van Beynum IM. Propranolol treatment in life-threatening airway hemangiomas: a case series and review of literature. Int J Pediatr Otorhinolaryngol. 2013 Nov;77(11):1791-800.

Costa JR, Torriani MA, Hosni ES, D’Avila OP, de Figueiredo PJ. Sclerotherapy for vascular malformations in the oral and masxillo-facial region: treatment and follow-up of 66 lesions. J oral maxillofac Surg. 2011 Jun:69(6):e88-92.

Redondo P. Vascular malformations (II). Diagnosis, Pathology, and Treatment. Actas Dermo-Sifiliográficas (English Edition). 2007 Jan 1;98(4):219-35.

Tieu DD, Ghodke BV, Vo NJ, Perkins JA. Single stage excision of localized head and neck venous malformations using preoperative glue embolization. Otolaryngol Head Neck Surg. 2013 Apr;148(4):678-84.

Vesnaver A, Dovsak DA. Treatment of large vascular lesions in the orofacial region with the Nd:YAG laser. J Craniomaxillofac Surg. 2009 Jun;37(4):191-5.

Turley RS1, Lidsky ME, Markovic JN, Shortell CK; Emerging role of contrast-enhanced MRI in diagnosing vascular malformations. Future Cardiol. 2014 Jul;10(4):479-86.

Murthy AS, Dawson A, Gupta D, Spring S, Cordoro KM. Utility and tolerability of the long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet (LP Nd: YAG) laser for treatment of symptomatic or disfiguring vascular malformations in children and adolescents. J Am Acad Dermatol. 2017;77(3):473-9.

Hartley A, Chalmers RL, Muir T. Vascular anomalies-inconsistencies remain. J Plas Reconst Aesthetic Surg. 2011 Apr 1;64(4):555-6.

Singh RK, Yadav MA. A case of vascular malformation; Med J Armed Forces India. 2014 Apr;70(2):201-2.

Judith N, Ulrike E, Siegmar R, Matthias N, Jürgen H. Current concepts in diagnosis and treatment of venous malformations. J Craniomaxillofac Surg. 2014 Oct;42(7):1300-4.

Aboelatta YA, Nagy E, Shaker M, Massoud KS. Venous malformations of Head and neck: diagnostic approach and a proposed management approach based on clinical, radiological, and histopathology findings. Head Neck. 2014 Jul;36(7):1052-7.

Kobayashi K, Nakao K, Kishishita S, Tamaruya N, Monobe H, Saito KI, et al. Vascular malformations of the head and neck. Auris Nasus Larynx. 2013 Feb 1;40(1):89-92.

Burns AJ1, Navarro JA. Role of laser therapy in pediatric patients. Plast Reconstr Surg. 2009 Jul;124(1 Suppl):82e-92e.

Liu X1, Fan Y, Huang J, Zeng R, Cao G, Chen M, et al. Can we predict the outcome of 595-nm wavelength pulsed dye laser therapy on capillary vascular malformations from the first beginning: a pilot study of efficacy co-related factors in 686 Chinese patients. Lasers Med Sci. 2015 Apr;30(3):1041-6.

Qiu Y1, Chen H, Lin X, Hu X, Jin Y, Ma G. Outcomes and complications of sclerotherapy for venous malformations. Vasc Endovascular Surg. 2013 Aug;47(6):454-61.

Tiwari R, Singh VK. Arterio-venous malformation of the face: surgical treatment. J Craniomaxillofac Oral Surg. 2015 Mar;14 (Suppl1):25-31.

Zhong LP1, Ow A, Yang WJ, Hu YJ, Wang LZ, Zhang CP. Surgical management of solitary venous malformation in the mid cheek region. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Aug;114(2):160-6.






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