Approach Considerations
The managing physician should arrange the proper consultations for the treatment of the patient.
Management of venous malformations may be more conservative or more aggressive depending on the individual's symptoms and the severity of the lesions. The location of the lesions, number of lesions, recurrences, progression of the lesions, and potential complications all are important factors to consider in treating venous malformations.
Symptomatic patients may benefit from anticoagulation, compression dressings, or sclerotherapy. [20] Some case reports have described antiangiogenic therapies, such as rapamycin injections, in the oncology literature, with varied success. [21, 22]
Neodymium-doped yttrium aluminum garnet (Nd:Yag) laser treatment has also been reported to effectively treat venous malformations [23] and may be efficacious for small, superficial lesions. [24]
Consider surgical excision in patients with symptomatic venous malformations in whom more conservative approaches have failed.
Consultations
The following consultations may be helpful:
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Radiologist: Radiography or computed tomography scanning should be periodically performed to evaluate bone changes.
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Orthopedic surgeon: An orthopedic surgeon should be consulted to evaluate bone changes and skeletal neoplasms and to help in treating fractures associated with this disease.
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Dermatologist: A dermatologist should be consulted to help evaluate venous malformations associated with this syndrome and to discover any new lesions on the skin.
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Characteristic venous malformations on the patient's right upper extremity. These vascular malformations are benign and asymptomatic.
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Enchondroma on the left elbow.
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Radiograph of a patient's hands showing enchondromas and phleboliths. Areas of translucency represent enchondromas, and opaque spots represent phleboliths.
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Venous malformations on a patient's right hand.
