Vascular malformations are non-cancerous growths or birthmarks formed by clusters of abnormal blood or lymphatic vessels. They can appear anywhere in the body. These malformations are congenital, meaning they are present at birth. Some vascular malformations may be inherited as an autosomal dominant trait. Types of vascular malformations include capillary, venous, arteriovenous, lymphatic, and complex combined malformations. Each type is named after the blood vessels involved, with unique characteristics such as visible discoloration in capillary malformations or a tangled network of vessels in arteriovenous malformations. Diagnosis often involves imaging techniques like ultrasound and MRI to assess the malformation’s structure, while treatments depend on the malformation type and severity. Minor malformations may only need observation, but others require interventions like sclerotherapy, laser therapy, or even surgery. More serious malformations, especially arteriovenous types, may need endovascular embolization or radiosurgery, especially when located near critical structures. With appropriate diagnosis and treatment, individuals with vascular malformations generally have a good prognosis and can live normal, healthy lives.
Vascular malformations are non-cancerous lesions or abnormal birthmarks made of a mass of irregular arteries, veins, capillaries or lymphatic vessels. There are many different types of vascular malformations, and each type is named according to the type of blood vessel that’s affected. Vascular malformations are also called lymphangioma, arteriovenous malformations or vascular gigantism. Vascular malformations are congenital conditions, which mean they are present at birth. The condition can be passed down from parent to child, as an autosomal dominant trait. This means that the child can inherit the condition from a single parent – Both parents do not need to have the condition. Vascular malformations can cause functional or aesthetic issues for the patient.
Vascular malformations do not appear to have any distinct cause. Most children born with vascular malformations do not have any direct family history of the condition. Vascular malformations may also be caused by developmental disorders in the womb. However, some types of vascular malformations can be inherited. Male and female infants have equal chances of being born with a vascular malformation. If you suspect that you or your partner have a gene that puts your child at risk of developing vascular malformation, you can consult a geneticist and attend genetic counselling.
Vascular malformations are present at birth, although they may not be noticed until later in life. They are named after the blood vessel that is most affected by the malformation:
Capillary Vascular Malformations – Capillary vascular malformations primarily affect the capillaries, where oxygen diffuses from the blood into the tissues. Capillary malformations result in flat patches of pink or purple skin. This patch can occur anywhere on the face and body and is called “port wine stains” in casual conversation. These occur in about 3 out of every 1000 newborns. The pink or abnormal purple color of the patch is a result of dilated capillaries just below the skin. The patches can grow proportionately with the child but generally do not spread further. The vessels tend to dilate and darken over time.
Venous Malformations – Venous malformations are abnormal clusters of dilated veins. They usually occur when the baby is still in the uterus. Venous malformations can be almost invisible, but many look like raised blue marks or bruises under the skin. As the baby grows, the abnormal veins dilate further and cause distortions in the skin above. Gravity plays a major role here – With higher malformations, the blood tends to flow and avoid swelling. As blood tends to pool in these areas, patients become more prone to blood clots. Blunt force can rupture these weak, dilated veins and result in hematomas.
Arteriovenous Malformations – Arteriovenous malformations are rare tangles of blood vessels that create abnormal connections between arteries and veins. Usually, arteries and veins do not connect directly but have capillaries connecting them. The oxygen transported by the blood in the arteries is released to the tissues in the capillaries. Oxygen-depleted blood then enters the vein and returns to the heart. Without the capillaries between them, pressurized blood from the arteries enters the veins directly. The veins are at risk of rupture. Arteriovenous malformations can occur anywhere in the vascular system but are especially dangerous when they occur in the brain.
Lymphatic Malformations – Lymphatic malformations are non-cancerous masses, consisting of a clump of lymph vessels. Lymphatic vessels are similar to veins, except they carry lymph, a watery fluid that is also part of the immune system. Lymphatic malformations look like lumps under the skin, made of fluid and soft tissue. They can form anywhere on the body except in the brain. Lymphatic malformations in the head and neck can cause airway and breathing issues in newborns. In the lower extremities, lymphatic malformations may appear at birth, or they may start swelling later in life, as gravity starts to accumulate lymph in the cluster.
Complex Combined Malformations – These are malformations that are a combination of at least 2 of the 4 malformations we have discussed above. Parkes-Weber syndrome is an example of this. It is a capillary malformation with an arteriovenous malformation, that results in overgrowth of the affected area.
The signs of vascular malformation are not always present at birth. If the child is born with clear symptoms of the condition, the doctor on duty will likely refer the child to the concerned specialist for diagnosis and treatment if required. However, sometimes children develop symptoms of these conditions later, as they grow. Then it falls on the parents to look out for the symptoms of the different types of malformations mentioned above and get medical treatment early.
Most vascular malformations are diagnosed on the basis of a physical exam and personal and family medical histories. Imaging tests provide helpful information about the structure of the vascular malformation and help confirm the diagnosis. Ultrasound scans and MRIs are the most common tests used to confirm the diagnosis. Sometimes, malformation may be biopsied to rule out cancer, but this is rare.
The child’s treatment program will be formulated based on the type of vascular malformation they have. Malformations that do not affect function or cause pain may be left as they are. These types of malformations, like the capillary malformations, will just be kept under observation. However, children with more serious conditions like arteriovenous malformations or complex combined malformations in the brain or spine will need long-term multi-disciplinary care.
Lymphatic and venous malformations are often treated with sclerotherapy. During the procedure, the radiologist injects a small amount of liquid sclerosant into the malformation, using X-rays for accurate placement. The liquid causes inflammation and scar tissue formation in the malformation and shrinks it over time. Sometimes, the malformations become enlarged again over time, and the procedure has to be repeated.
Endovenous laser ablation is a minimally invasive technique used to treat venous malformations. An interventional radiologist performs the procedure. A thin catheter is inserted guided to the malformed vessels, using X-ray fluoroscopy. A laser is threaded through the catheter and used to damage the walls of the malformed vessels with heat. The malformed vessels shrink with laser therapy, and the body reroutes the blood supply through healthy blood vessels. Laser therapy is often used in combination with Sclerotherapy for better outcomes.
Arteriovenous malformations are one of the more severe types of vascular malformation. The main method of treatment for arteriovenous malformations is surgical removal. However, this only applies to malformations that aren’t in the brain, or any other area prone to a lot of bleeding. Arteriovenous malformations in sensitive areas may be treated with Endovascular Embolization or Stereotactic Radiosurgery. Endovascular embolization works by blocking the blood flowing into the arteriovenous malformation. This procedure is minimally invasive and reduces the risk of heavy blood loss. During the procedure, the surgeon injects a glue-like substance or coils into the malformation through a catheter. The glue sets in place, like superglue, and blocks entry into the malformation. Stereotactic radiosurgery is another technique that can be used to treat arteriovenous malformations in the brain. A high dose of radiation is delivered very precisely to the malformation, destroying it and causing the blood vessels to close off. This technique is very effective on small to medium sized arteriovenous malformations.
The long-term prognosis for children with vascular malformations is generally good, if they are diagnosed and treated correctly. Some types of malformations cause no problems and only require observation and routine follow-ups. Certain malformations cause pain and swelling, interfere with movement and can put a strain on the heart. The aesthetics of the malformations could also affect the child’s self-esteem as they grow up. However, a vast majority of malformations are treatable with a high rate of success. Children with vascular malformations can go on to lead a normal and healthy life despite their condition.
If you or your child is affected by vascular malformations, early and expert care is essential. Our Interventional Radiology Department offers comprehensive diagnosis and treatment of vascular malformations, ensuring safe, effective, and personalized care for every patient. With advanced imaging, minimally invasive techniques, and compassionate follow-up, we help patients achieve long-term wellness and confidence.
Vascular malformations are usually congenital, meaning they are present at birth. They occur due to abnormal development of blood or lymphatic vessels during fetal growth. In most cases, the exact cause is unknown, but some types can be inherited through genetic mutations.
Not exactly. While some vascular malformations may look like birthmarks, they are deeper abnormalities involving veins, arteries, capillaries, or lymph vessels. Unlike simple skin birthmarks, vascular malformations can grow with the child and sometimes cause pain, swelling, or functional issues.
Doctors usually perform a physical exam followed by imaging tests such as ultrasound, MRI, or CT scans to identify the type and extent of the malformation. In rare cases, a biopsy may be done to rule out other conditions.
Treatment depends on the type and severity of the malformation. Common options include sclerotherapy, laser therapy, Endovenous laser ablation, embolization, radiosurgery, or surgical removal. Some minor cases are only monitored through regular follow-ups.
Most vascular malformations do not disappear naturally. However, some small or non-problematic ones may remain stable throughout life and not require active treatment unless they cause symptoms or cosmetic concerns.
With timely diagnosis and proper treatment, most children with vascular malformations can lead normal, healthy lives. Follow-up care is important to manage any recurrence or complications as they grow..
Interventional Radiology offers minimally invasive treatments for vascular malformations using image-guided techniques like sclerotherapy, laser ablation, and embolization. These procedures target abnormal vessels precisely, reduce pain, and support faster recovery compared to open surgery.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet, Vadapalani & Radial Road), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and paediatric trauma care.
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