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A multi-disciplinary, multimodal approach for the management of vascular anomalies
Author(s):
1. Aqsa Mazhar: Center for Essential Surgical and Acute Care,Global Health Directorate, Indus Health Network,Karachi, Pakistan
2. Shazia Moosa: Center for Essential Surgical and Acute Care, Global Health Directorate, Indus Health Network,Karachi,Pakistan
3. Alizeh Abbas: Center for Essential Surgical and Acute Care, Global Health Directorate, Indus Health Network,Karachi,Pakistan
4. Yousuf Mallick: Center for Essential Surgical and Acute Care, Global Health Directorate, Indus Health Network,Karachi,Pakistan
5. Lubna Samad: Center for Essential Surgical and Acute Care, Global Health Directorate, Indus Health Network,Karachi,Pakistan
Abstract:
Objective: Vascular anomalies are a diverse group of lesions, ranging from simple to complex, disfiguring anomalies. Our objective was to diagnose and provide comprehensive treatment to patients presenting with vascular anomalies, using a multi-disciplinary approach involving dermatologists, plastic surgeons, radiologists and pediatric surgeons. Methods: Patients presenting with vascular anomalies to The Indus Hospital, Karachi, from January 2017 to March 2019 were enrolled, using a pre-defined questionnaire. Assessment, diagnostic work up, management and clinical and photographic follow up was maintained to monitor outcomes. Results: One hundred eighty seven patients with a mean age of 4.6 years, (females 62%) were enrolled. Diagnoses included vascular tumors (n=89, 47.6%), lymphatic malformations (n=38, 20.3%), capillary malformations (n=19, 10%), venous malformations (n=16, 8.5%), arterio-venous malformations (n=14, 7.5%) and mixed anomalies (n=11, 5.9%). Treatment modalities, in isolation or combination, included oral propranolol, topical timolol, pulsed dye laser and intra-lesional sclerotherapy. Mean follow up was in 7.1 months, with 27 patients achieving treatment completion. 26 children were lost to follow-up. Conclusions: Vascular anomalies have mostly been managed successfully at VAC using single or multimodal treatment. Increasingly complex anomalies can be handled using a multi-disciplinary approach. Establishment of VAC has facilitated many patients who were earlier considered as diagnostic and therapeutic challenges.
Page(s): 4-9
DOI: DOI not available
Published: Journal: Pakistan Journal of Medical Sciences, Volume: 36, Issue: 1, Year: 2020
Keywords:
PDL Pulsed dye laser , VAC Vascular Anomalies Center , Vascular anomalies
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