Expression of endoglin (CD105) and endothelial nitric oxide synthase in head and neck arteriovenous malformations.

Importance: Endoglin (CD105) and endothelial nitric oxide synthase (eNOS) assist in regulating vascular development. Variation in expression of these factors is linked to errors in vascular growth and remodeling in invasive lesions.

Objective: To clarify the role of endoglin and eNOS in the growth of extracranial head and neck arteriovenous malformations (AVMs), an invasive and high-flow vascular anomaly.

Current management of infantile hemangiomas and their common associated conditions.

This article reviews the most current practice guidelines in the diagnosis and treatment of infantile hemangiomas. Several systemic conditions that can be associated with hemangiomas, such as PHACES syndrome, are also discussed. Propranolol has become an effective first-line treatment, and protocols for its use as well as its potential risks are outlined.

A pilot in vivo model of human microcystic lymphatic malformations.

Objective: To develop an in vivo mouse model of human microcystic lymphatic malformations (LMs) and provide a tool for investigating the biological mechanisms and treatment of microcystic disease.

Design: Animal model and histologic analysis.

Setting: Tertiary referral center.

Preliminary investigation of human lymphatic malformations in vitro.

Purpose: To develop an in vitro model of human lymphatic malformations (LM) that reflects histological characteristics of native LM.

Methods: Fresh human LM (n = 6) were harvested, sectioned, explanted into a fibrinogen gel, and cultured. A total of 25 explants were developed and observed for primary and peripheral cellular growth.

Preoperative sclerotherapy of facial venous malformations: impact on surgical parameters and long-term follow-up.

Purpose: To analyze the operative benefit of preoperative sclerotherapy of facial venous malformations and assess long-term patient outcome.

Materials And Methods: Preoperative sclerotherapy was performed in 24 consecutive patients referred before resection of facial venous malformation. Pretreatment imaging was reviewed for malformation dimensions (length, width, and height), and volumes were estimated.

Endoscopic management of airway venous malformations with Nd:YAG laser.

Objectives: The neodymium:yttrium-aluminum-garnet (Nd:YAG) laser is a powerful tool in treating venous malformations (VMs) involving the upper airway. If left untreated, laryngeal VMs can lead to life-threatening airway obstruction. We aimed to evaluate the efficacy of endoscopic management of laryngeal VMs with the Nd:YAG laser.

Propranolol for infantile hemangiomas: early experience at a tertiary vascular anomalies center.

Objectives/hypothesis: Propranolol has recently been introduced as a novel pharmacologic treatment for infantile hemangiomas. Systematic examination of this treatment in a tertiary care setting has not been described. This study explores the impact of propranolol on both proliferative and involuting hemangiomas at a tertiary vascular anomalies center.

Diagnosis and management of pediatric cervicofacial venous malformations: retrospective review from a vascular anomalies center.

Objectives/hypothesis: Venous malformations are rare congenital aberrations of vein development frequently presenting in the head and neck. Without treatment, venous malformations cause progressive disfigurement, dysfunction, and bleeding. In this study, we analyzed a cohort of pediatric patients with cervicofacial venous malformations (CFVM), with the goal of developing a treatment algorithm for these complex lesions.

Propranolol treatment for infantile hemangiomas.

Purpose Of Review: Infantile hemangiomas are the most common benign tumors of infancy and the majority of them occur in the head and neck. Recent literature has described propranolol for the treatment of these vascular tumors.

Recent Findings: Propranolol was serendipitously found to induce early involution in hemangiomas even during the proliferative phase of the hemangioma cycle.

CO2 laser resurfacing of intraoral lymphatic malformations: a 10-year experience.

Objective: To evaluate the safety and efficacy of CO(2) laser resurfacing in the symptomatic treatment of intraoral lymphatic malformations (LM).

Design: Retrospective review.

Methods: Charts were reviewed on 26 patients (16 male, 10 female) from January 1997 to July 2007 who underwent CO(2) laser resurfacing for symptomatic treatment of intraoral LM.

Intralesional steroid injection for proliferative parotid hemangiomas.

Objective: To evaluate the efficacy of proliferative phase intralesional steroid injections in the treatment of parotid hemangiomas.

Design: Retrospective analysis of pediatric patients with parotid hemangiomas treated with intralesional steroid injections during the proliferative phase.

Setting: Vascular Anomalies Center, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA.

Use of recombinant factor VIIa during excision of vascular anomalies.

Background: The surgical excision of vascular anomalies is often accompanied with significant perioperative bleeding. Novel hemostatic agents, including recombinant factor VIIa (rVIIa), have been shown to reduce bleeding in hemophilia and trauma patients along with decreasing blood loss during various surgical procedures. The role of rVIIa during excision of vascular anomalies has not been examined.

Arteriovenous malformations of the tongue: a spectrum of disease.

Objectives: To examine our vascular anomalies team's experience with tongue arteriovenous malformations (AVM) with specific emphasis on the spectrum on disease and surgical management.

Methods: Retrospective chart review of 11 patients (10 female, 1 male), discovered from 1997 to 2005 with histological, radiographic, and clinical characteristics consistent with tongue AVM.

Results: Four patients displayed advanced disease with malformations involving the tongue, floor of mouth, and neck.

Mathematical modeling of selective photothermolysis to aid the treatment of vascular malformations and hemangioma with pulsed dye laser.

Pulsed dye lasers (PDL) are the standard of care in the treatment of cutaneous vascular disorders such as the port-wine strains or hemangiomas of infancy. Nonetheless, there is still uncertainty regarding the specific laser parameters that are likely to yield optimal clinical outcomes. Using mathematical modeling, we explain and associate clinical outcomes with laser wavelength, radiant exposure, and pulse time and shape.

Update on hemangiomas and vascular malformations.

Purpose Of Review: Our knowledge base in the area of vascular anomalies is growing rapidly. With greater understanding of classification and diagnosis, as well as with the numerous areas of research bringing further awareness on the complexity of these lesions, we are improving our ability to treat them. We will attempt in this article to summarize the developments in the field of vascular anomalies over the last year.