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Vascular Surgery 2019
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Page 48
March 28-29, 2019
Rome, Italy
Vascular Surgery
4
th
Edition of World Congress & Exhibition on
Congenital vascular malformations: features of diagnosis
and complex treatment
Chernukha L M, O V Kashyrova, A O Guch, G G Vlaykov, О A Vlasenko, I V Alt-
man, V A Kondratyuk
and
I V Gomolyako
National Institute of Surgery and Transplantology, Ukraine
Chernukha L M et al., J Vasc Endovasc Therapy 2019, Volume 4
DOI: 10.21767/2573-4482-C1-005
Introduction:
Congenital
vascular
malformations
(CVM) occur in 1.5-10% of the total population. Various
manifestations of CVM cause difficulties in diagnosis and
treatment, resulting in disability and sometimes, death of
the patient.
Methods:
The data of 630 patients with CVM (period
2005-2016) were analysed, females predominated (55%),
and average age was 25.5. Ultrasound duplex scanning,
selective arteriography, phlebography, multidetected
computed
tomography,
pathomorphological
and
immunohistochemical studies (proliferation markers
VEGF, Ki-67), study of the hemostasis (D-dimer, soluble
fibrin, fibrinogen) and fibrinolytic system (protein C) were
investigated.
Results:
The source of proliferation of both forms of CVM
(venous and arteriovenous (AV)), given the level of VEGF
and Ki-67 expression, is precisely the microcirculatory
vasculature, due to the presence of existing AV
microfistulas. It was discovered the significant activation
of coagulation capacity in preoperative period in patients
with AV CVM (23): 9 (39%) patients had significantly
increased plasma fibrinogen content (from 3.7 to 7.2 g/l),
10 (43.5%) - soluble fibrin (from 3.6 to 50 μg/ml), in 7
(30.4%) - D-dimer (from 119.3 to 1608.3 ng/ml); the activity
of protein C in 95% of patients corresponded to the norm/
changes in the postoperative period depended on the
clinical-anatomical form of CAVM and type (radicality) of
the intervention. Treatment strategy include: Endovascular
methods (embolization with the use of non-spherical PVA
particles) during preoperative stage and combination of
surgical, embolization, laser and sclerotic methods in
perioperative stage; Correction of AV shunting separately
or in conjunction with venous hypertension correction;
Correction of secondary venous hypertension in superficial
and/or deep venous systems; Correction of lymphatic
outflow (lymphodrenation, lymphangioplasty, and lipo-
lympho-aspiration, lymphovenous anastomoses) and; In
cases of severe pain syndrome neurolysis with fascicullary
dissection were performed.
Conclusions:
The introduced pathogenically based
approach allowed obtaining satisfactory results in 94.4% of
patients.
Recent Publications
1. Chernukha L et al. (2016) Epidemiological
aspects of comorbidity of lower limbs chronic
venous disease (CVD) and haemorrhoids: the
results of detect-duo. Іnt Angіol. 35(1-2):83.
2. L M Chernukha, O V Kashyrova, A O Guch, G
G Vlaykov, O A Vlasenko, V A Kondratuk and
I V Gomolyako (2017) Congenital vascular
malformations: features of diagnosis and
treatment (2017) The Hungerian Journal of
Vascular Diseases XXIV(3):17-18.