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Semin intervent Radiol
DOI: 10.1055/s-0045-1809627
Review Article

Recent Advances in Interventional Management of Extracranial Vascular Malformations in Children

K.F. Kevin Fung 
1   Department of Radiology, Hong Kong Children's Hospital, Kowloon Bay, Hong Kong
2   Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, Canada
,
Moritz Wildgruber 
3   Department of Radiology, University Hospital Munich, LMU Munich, Munich, Germany
,
Frederic J. Bertino
4   Interventional Radiology Section, Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
,
Jay H. Shah
5   Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
› Author Affiliations
Funding This study was not supported by any funding.
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Abstract

Vascular malformations are congenital abnormalities arising from dysregulated angiogenesis, often due to gain-of-function somatic mutations. Extracranial disease involvement can cause significant pain, disfigurement, and functional limitations. Conventional sclerosing agents such as ethanol, sodium tetradecyl sulfate, and doxycycline are effective in treating the majority of slow-flow vascular malformations. However, these sclerosants have limited efficacy in lesions with significant lipomatous or stromal components and can be associated with significant local toxicity, especially if extravasated. The wider adoption of bleomycin and new interventional techniques such as bleomycin electrosclerotherapy using reversible electroporation and percutaneous thermal ablative modalities has shifted treatment paradigms for challenging cases which are refractory to conventional sclerosants. This article aims to provide an overview of these recent advances in interventional techniques and to highlight the importance of the integration of personalized precision medicine in the multidisciplinary care of children with extracranial vascular malformations.

Keywords

vascular malformation - sclerotherapy - bleomycin - electrosclerotherapy - interventional radiology

Compliance with Ethical Standards

- This article does not contain any studies with human participants or animals performed by any of the authors. Formal institutional board approval is waived for this type of study.


- For this type of study, formal consent is not required.


- For this type of study, consent for publication is not required.




Publication History

Article published online:
17 June 2025

© 2025. Thieme. All rights reserved.

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