Diagnosis and Surgical Aspects of Congenital Venous Angiodysplasia in the Extremities

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Abstract
An evaluation of the treatment of patients with venous angiodysplasia and severe chronic insufficiency. The clinical series of patients with venous angiodysplasia of Klippel-Trenaunay (K-T) and Servelle-Martorell (S-M) type. Primary care teaching hospital. Eighty-three patients with angiodysplasia type K-T characterized by the triad of local giantism, varicose veins and naevus flammeus. Malformations of the deep venous system were present in 96%. The predominant vascular lesion in patients with the S-M syndrome (n=34) was a haemangiomatosis, involving both the skeleton and soft tissues, causing growth retardation in the affected extremity. A malformation of the deep venous system could be seen in all patients. Healing of skin ulcers and varicose bleeding of the lower extremities. Conservative treatments included external compression bandages or stockings. In 14 patients, surgical extirpation of superficial veins was used. All the ulcers were treated successfully, and no haemorrhage reoccurred. Haemodynamic studies showed an improvement of the venous reflux disease in 86% of patients. Venous angiodysplasia of the lower extremity is nearly always associated with malformation of the deep venous system. Surgery is indicated for the elimination of a pathological short circuit flow in atypical drainage veins of the affected leg, especially when skin lesions are present. For any type of surgery, a careful preoperative angiographic and haemodynamic evaluation is mandatory.

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