Combined vascular malformation of neck: A case report

Vascular malformations are developmental anomalies occurring due to defective vasculogenesis. Depending on the number of vessels involved, they are subgrouped into simple or combined types. Combined vascular malformations are a rare clinical entity with two or more vascular malformations (capillary, venous, arteriovenous, lymphatic) present in one lesion. Due to the complexity of these lesions, clinicians should employ an interdisciplinary approach with multi-staged treatment for the proper management. Here, we report a case of a lady with a combined vascular malformation in the right side of the neck who presented to our department with a complaint of progressively increasing swelling for three months. A multidisciplinary team of vascular surgeons, interventional radiologists and physiotherapists were involved in its treatment. Initially, Doppler ultrasonography was performed, which revealed a vascular lesion with arterial and venous components and a flow void region suggestive of lymphatic malformation, further confirmed by magnetic resonance imaging (MRI). A multistage treatment modality was employed where intralesional steroid was initially administered in the lesion area to shrink the vessel's size. Next, venous malformation targeted sclerotherapy was performed preoperatively, followed by intraoperative ligation of the feeding vessel and excision of remaining malformation. Postoperatively the patient had no wound site complication and was discharged on the fourth postoperative day with advice to follow rehabilitative neck exercises. One month follow-up revealed complete resolution of the malformation. Thus, in the case of combined vascular malformation, multistage treatment modalities with a multidisciplinary team should be employed for proper treatment.

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A rare case of combined arterio-lymphatico-venous malformation on the right side of the neck.

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Successful multimodal treatment by intralesional steroid injection, ligation of feeding vessel, resection of malformation, and sclerotherapy.

Investigation on coagulation efficiency of polyaluminium silicate chloride (PASiC) coagulant

Polyaluminium silicate chloride (PASiC) coagulant was synthesized by co-polymerization technique using aluminium salt and polysilicic acid at different OH/Al and Al/Si molar ratios. A synthetic turbid sample was used to investigate the coagulation efficiency of the prepared coagulant. After the coagulant dosing, flocculation time was set for 15 minutes followed by sedimentation for 20 minutes.  High performance of coagulant was achieved at 2.5 molar ratio of OH/Al and 5 molar ratio of Al/Si at the optimal pH. The optimum pH range was found to be 7±0.5.The effective coagulant dose for the efficient removal of turbidity was set as 2.5 mg/L. As compared to conventional alum, PASiC has been found to be excellent inorganic polymeric coagulant for turbidity removal from water and residual aluminum was found to be minimal in comparison to conventional alum treatment. Hence, PASiC has proven the potentiality for the turbidity removal in water treatment over conventional alum. Scientific World, Vol. 10, No. 10, July 2012 p33-37 DOI: http://dx.doi.org/10.3126/sw.v10i10.6859