Classification, Imaging, and Interventional Procedures in Peripheral Congenital Vascular Anomalies

Abstract

Classification of vascular lesions is often confusing and various systems have been described. Pathologically, they can be classified as capillary, cavernous, venous, arteriovenous, lymphatic, and mixed types. Another pathologic classification describes them in two groups including hemangiomas and vascular malformations. Vascular lesions can also be classified for low and high flow lesions depending of blood flow velocity in the lesion. Although vascular lesions are congenital but they may not be evident until adulthood. Imaging modalities that can be used for evaluation of vascular anomalies include: conventional radiography, ultrasonography, CT Scan, MRI, catheter angiography, CT and MR angiography. MRI is the most valuable modality in the classification and diagnosis of vascular lesions. Other modalities also have important roles in diagnosis of problematic lesions and also in interventional procedures such as percutaneous treatment. Most of vascular lesions can be treated conservatively, but some of them especially high flow lesions need interventional treatment and in such lesions, usually a multidisciplinary approach is necessary. Embolization and sclerotherapy are the most used interventional techniques. The aim of this review is describing not only the multiple classification systems of peripheral vascular anomalies, but also more importantly the diagnostic role of different imaging modalities and also embolization or sclerotherapy planning for control of them.