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Wassef M, Borsik M, Cerceau P, Faucon B, Laurian C, Le Clerc N, Lemarchand-Venencie F, Massoni C, Salvan D, Bisdorff-Bresson A. [Classification of vascular tumours and vascular malformations. Contribution of the ISSVA 2014/2018 classification]. Ann Pathol 2020; 41:58-70. [PMID: 33309330 DOI: 10.1016/j.annpat.2020.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 12/17/2022]
Abstract
The study of vascular anomalies, "angiomas", vascular tumours and vascular malformations is made difficult by the great variety and confusion of the names used in the literature for these diseases, some of which are rare. The great merit of the classification proposed by the International Society for the Study of Vascular Anomalies (ISSVA), adopted in 2014 and modified in 2018, is to propose a unambiguous nomenclature and to try to group these lesions in a logical way, contrasting with the lists of the usual "classifications". This classification is based on the distinction between proliferative lesions (tumours and reactive lesions) and those which are due to a congenital anomaly of vascular morphogenesis (vascular malformations). It incorporates recent data on the molecular causes of these diseases. The major groups of lesions recognised in this classification will be presented and some lesions of interest briefly discussed. This classification aims to be usable by all medical specialties and applicable to all tissues and organs, even if efforts are still needed to integrate organ-specific names in order to unify the nomenclature and eliminate confusion. Even if it does not solve all the problems in this complex field, the unification of the nomenclature is a major contribution of this classification and pathologists are strongly encouraged to refer to it in daily practice.
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Affiliation(s)
- Michel Wassef
- Service d'anatomie et cytologie pathologiques, hôpital Lariboisière, APHP ; UFR de médecine Paris nord, université de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex, France; Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France.
| | - Michel Borsik
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Maison médicale, 9, rue Jean-Jacques-Bernard, 60200 Compiègne, France
| | - Pierre Cerceau
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Service de chirurgie vasculaire et thoracique, hôpital Bichat, APHP, 46, rue Henri-Huchard, 75018 Paris, France
| | - Benoit Faucon
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Service d'ORL, Centre hospitalier de Pontoise, 6, avenue de l'Île-de-France, 95300 Pontoise, France
| | - Claude Laurian
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Service de chirurgie vasculaire, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Nicolas Le Clerc
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Service d'ORL, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France
| | - Françoise Lemarchand-Venencie
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France
| | - Claudine Massoni
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Cabinet médical, 7, rue Chalgrin, 75116 Paris, France
| | - Didier Salvan
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France; Service d'ORL, centre hospitalier Sud Francilien, 40, avenue Serge-Dassault, 91100 Corbeil Essonnes, France
| | - Annouk Bisdorff-Bresson
- Consultation des angiomes, service de neuroradiologie, hôpital Lariboisière, APHP, 2, rue Ambroise-Paré 75475 Paris cedex, France
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Laroche JP, Blaise S, Becker F, Laaeng Massoni C, Nou-Howaldt M, Pichot O, Desmurs-Clavel H, Jeancolas J, Jurus C, Sarlon-Bartoli G, Soulier-Sotto V, Thiel H, Sevestre-Pietri MA, Maloizel-Delaunay J, Mestre-Godin S. [Quality standards for ultrasonographic assessment of peripheral vascular malformations and vascular tumors. Report of the french society for vascular medicine. 2018 Update]. J Med Vasc 2018; 43:36-51. [PMID: 29425539 DOI: 10.1016/j.jdmv.2017.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 11/02/2017] [Indexed: 06/08/2023]
Abstract
UNLABELLED The quality standards of the French Society of Vascular Medicine for the ultrasonographic assessment of vascular malformations are based on the two following requirements: (1) technical know-how: mastering the use of ultrasound devices and the method of examination; (2) medical know-how: ability to adapt the methods and scope of the examination to its clinical indication and purpose, and to rationally analyze and interpret its results. AIMS OF THE QUALITY STANDARDS To describe an optimal method of examination in relation to the clinical question and hypothesis. To homogenize practice, methods, glossary, and reporting. To provide good practice reference points, and promote a quality process. ITEMS OF THE QUALITY STANDARDS The 3 levels of examination; their clinical indications and goals. The reference standard examination (level 2), its variants according to clinical needs. The minimal content of the examination report; the letter to the referring physician (synthesis, conclusion and proposal for further investigation and/or therapeutic management). Commented glossary (anatomy, hemodynamics, semiology). Technical bases. Setting and use of ultrasound devices. Here, we discuss ultrasonography methods of using of ultrasonography for the assessment of peripheral vascular malformations and tumors (limbs, face, trunk).
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MESH Headings
- Adult
- Blood Coagulation Disorders/blood
- Blood Coagulation Disorders/etiology
- Blood Flow Velocity
- Clinical Competence
- Disease Progression
- Eye Neoplasms/diagnostic imaging
- Female
- Fibrin Fibrinogen Degradation Products/analysis
- Fibrinogen/analysis
- Hemangioma/diagnostic imaging
- Hemodynamics
- Humans
- Infant
- Lymphangioma, Cystic/diagnostic imaging
- Male
- Quality Assurance, Health Care
- Ultrasonography, Doppler, Color/instrumentation
- Ultrasonography, Doppler, Color/methods
- Ultrasonography, Doppler, Duplex/instrumentation
- Ultrasonography, Doppler, Duplex/methods
- Ultrasonography, Doppler, Duplex/standards
- Vascular Malformations/blood
- Vascular Malformations/classification
- Vascular Malformations/complications
- Vascular Malformations/diagnostic imaging
- Vascular Neoplasms/diagnostic imaging
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Affiliation(s)
- J P Laroche
- Médecine vasculaire, médecine interne B, hôpital Saint-Eloi, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - S Blaise
- Département de médecine vasculaire, CHU Grenoble Alpes, 38000 Grenoble, France.
| | - F Becker
- Service d'angiologie et d'hémostase, hôpitaux universitaires de Genève, hôpital Cantonal, 1205 Genève, Suisse
| | | | - M Nou-Howaldt
- Médecine vasculaire, médecine interne B, hôpital Saint-Eloi, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - O Pichot
- Département de médecine vasculaire, CHU Grenoble Alpes, 38000 Grenoble, France
| | - H Desmurs-Clavel
- Hospices civils de Lyon, service de médecine interne, hôpital Édouard-Herriot, 5, rue d'Arsonval, 69437 Lyon, France
| | - J Jeancolas
- Médecine vasculaire, CHU Caen, avenue de la Côte de Nacre, 14033 Caen, France
| | - C Jurus
- Médecine vasculaire, clinique du Tonkin, 26, rue du Tonkin, 69100 Villeurbanne, France
| | - G Sarlon-Bartoli
- Médecine vasculaire, CHU La Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - V Soulier-Sotto
- Médecine vasculaire, médecine interne B, hôpital Saint-Eloi, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - H Thiel
- Médecine vasculaire, CHU Clermont-Ferrand, hôpital Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - M A Sevestre-Pietri
- Médecine vasculaire, Site Sud, CHU d'Amiens-Picardie, 80054 Amiens cedex 1, France
| | - J Maloizel-Delaunay
- Médecine vasculaire, CHU Rangueil, 1, avenue du Professeur Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France
| | - S Mestre-Godin
- Département de médecine vasculaire, CHU Grenoble Alpes, 38000 Grenoble, France
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Abstract
Vascular medicine plays a determining role in the management of vascular malformation, especially venous malformations. Ideally, therapeutic decision should be made in a multidisciplinary staff meeting. Vascular medicine plays the leading role for diagnosis and duplex-Doppler evaluation of coagulation disorders, potentially associated with an assessment of treatment feasibility using chemical or thermic endovascular techniques. Potential adherence of compression therapy must also be evaluated. Decision trees often mention sclerotherapy for the management of venous malformations. Echo-guided foam sclerotherapy is preferred. The superiority of foam sclerotherapy over liquid sclerotherapy has been demonstrated. Indications and limitations of this specific treatment remain to be definitively determined, especially for treatments with radiological control. Side effects are now well described for the use of foam sclerotherapy for venous malformations. They remain limited. Future developments should help optimize the sclerosing effect of currently used foams or other products to be developed. For the vascular medicine specialist, the main contribution is to define the appropriate use of echo-guided sclerotherapy.
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Affiliation(s)
- S Blaise
- Clinique universitaire de médecine vasculaire, centre hospitalier universitaire de Grenoble Alpes, BP 217, 38043 Grenoble cedex 09, France; UMR 1042-HP2, Inserm, université Grenoble Alpes, 38000 Grenoble, France.
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4
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Elajmi A, Clapuyt P, Hammer F, Bataille AC, Lengele B, Boon LM. [Management of vascular anomalies in children]. ANN CHIR PLAST ESTH 2016; 61:480-497. [PMID: 27641115 DOI: 10.1016/j.anplas.2016.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 01/19/2023]
Abstract
Vascular anomalies, which are broadly identified as "angiomas", are rare entities and often unknown by the medical sphere. They are divided in two different categories which carry different prognosis and management: "vascular tumors" and "vascular malformations". Their precise identification is crucial and involves a good knowledge of the biological classification published by Mulliken and Glowacki and that has recently been updated by the International Society for the Study of Vascular Anomalies (ISSVA). Vascular tumors are benign, common, inborn or not and most of the time disappear with growth. Vascular malformations are always congenital and growth with the child. They can involve type of vessels solely or combined with others. A rheologic differentiation between slow and fast flow malformations is essential in order to characterize the seriousness of the lesion. Frequently, their diagnosis is clinically established and the anamnesis is conducted to answer three questions that are the time of revelation of the lesion ("When?"), its aspect ("What?") and its evolution ("How?"). Further investigations are usually not required but a non-invasive imaging technique such as Doppler ultrasound could be useful if a doubt exists. Surgery is not mandatory and must always be well thought because its consequences might be disastrous. It must be left to cosmetic sequelae of these lesions or to lesions that are totally resectable without causing any unacceptable deformation.
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Affiliation(s)
- A Elajmi
- Service de chirurgie plastique, centre des anomalies vasculaires, cliniques universitaires Saint-Luc, 10, avenue Hippocrate, 1200 Bruxelles, Belgique
| | - P Clapuyt
- Service de radiologie pédiatrique, centre des anomalies vasculaires, cliniques universitaires Saint-Luc, Bruxelles, Belgique
| | - F Hammer
- Service de radiologie interventionelle, centre des anomalies vasculaires, cliniques universitaires Saint-Luc, Bruxelles, Belgique
| | - A-C Bataille
- Service de chirurgie plastique, centre des anomalies vasculaires, cliniques universitaires Saint-Luc, 10, avenue Hippocrate, 1200 Bruxelles, Belgique
| | - B Lengele
- Service de chirurgie plastique, centre des anomalies vasculaires, cliniques universitaires Saint-Luc, 10, avenue Hippocrate, 1200 Bruxelles, Belgique
| | - L M Boon
- Service de chirurgie plastique, centre des anomalies vasculaires, cliniques universitaires Saint-Luc, 10, avenue Hippocrate, 1200 Bruxelles, Belgique.
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5
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Labau D, Cadic P, Ouroussoff G, Ligeron C, Laroche JP, Guillot B, Dereure O, Quéré I, Galanaud JP. [Therapeutic indications for percutaneous laser in patients with vascular malformations and tumors]. ACTA ACUST UNITED AC 2014; 39:363-72. [PMID: 25086985 DOI: 10.1016/j.jmv.2014.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 05/28/2014] [Indexed: 10/25/2022]
Abstract
Lasers are increasingly used to treat vascular abnormalities. Indeed, this technique is non-invasive and allows a specific treatment. The aim of this review is to present some biophysical principles of the lasers, to describe the different sorts of lasers available for treatment in vascular medicine indications. Three principal lasers exist in vascular medicine: the pulsed-dye laser, for the treatment of superficial pink lesions, the NdYAG-KTP laser for purple and bigger lesions, and the NdYAG long pulse laser for even deeper and bigger vascular lesions. In vascular malformations, port wine stains can also be treated by pulsed-dye laser, KTP or NdYAG when they are old and thick. Telangiectasias are good indications for the three sorts of lasers, depending on their depth, color and size. Microcystic lymphatic malformations can be improved by laser treatment. Arterio-venous malformations constitute a contraindication of laser treatment. In vascular tumors, involuted infantile hemangiomas constitute an excellent indication of pulsed-dye laser treatment. Controlled studies are necessary to evaluate and to compare the efficacy of each laser, in order to determine their optimal indications and optimal parameters for each machine.
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Affiliation(s)
- D Labau
- Centre d'investigation clinique, service de médecine interne et vasculaire, hôpital Saint-Éloi, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Service de dermatologie, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - P Cadic
- Cabinet de laser médical, 45000 Orléans, France
| | - G Ouroussoff
- Cabinet de médecine vasculaire, 91310 Montlhéry, France
| | - C Ligeron
- Consultation de dermatologie, clinique du Parc, 34170 Castelnau-Le-Lez, France
| | - J-P Laroche
- Centre d'investigation clinique, service de médecine interne et vasculaire, hôpital Saint-Éloi, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - B Guillot
- Service de dermatologie, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - O Dereure
- Service de dermatologie, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - I Quéré
- Centre d'investigation clinique, service de médecine interne et vasculaire, hôpital Saint-Éloi, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - J-P Galanaud
- Centre d'investigation clinique, service de médecine interne et vasculaire, hôpital Saint-Éloi, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
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