Management of Vascular Malformations in the Thorax Wall

  • Francesco Stillo
  • Giuseppe Bianchini


Vascular malformations of the thoracic wall are relatively rare but highly disabling as they cause severe functional and aesthetic disorders. Treatment of thorax vascular malformations is extremely difficult and dangerous for the patient. Therapeutic strategy must be planned for each patient on the basis of clinical and instrumental findings, considering the site, morphology, extent and the hemodynamics of the malformation. Treatment options differ depending on the various types of thoracic vascular malformation: venous, lymphatic or arteriovenous. The most common surgical and endovascular procedures carried out in the treatment of thorax vascular malformations are discussed and described in this chapter, with particular reference to the therapeutic problems and risks in this specific anatomical region.


Arteriovenous Malformation Vascular Malformation Thoracic Wall Venous Malformation Lymphatic Malformation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Waldo RT (1991) Chest wall vascular malformations. Chest 100:887–888CrossRefPubMedGoogle Scholar
  2. 2.
    Arneja JS, Gosain AK (2006) An approach to the management of common vascular malformations of the trunk. J Craniofac Surg 17:761–766CrossRefPubMedGoogle Scholar
  3. 3.
    Demos TC, Posniak HV, Pierce KL, et al (2004) Venous anomalies of the thorax. AJR Am J Roentgenol 82:1139–1150Google Scholar
  4. 4.
    Bianchini G, Nicodemi EM, Stillo F (2003) Thoraco-abdominal venous malformations: diagnostic and therapeutic strategies. International Angiology 22(2 supp 1):69Google Scholar
  5. 5.
    O’Donovan JC, Donaldson JS, Morello FP et al (1997) Symptomatic hemangiomas and venous malformations in infants, children, and young adults: treatment with percutaneous injection of sodium tetradecyl sulfate. AJR Am J Roentgenol 169:723–729PubMedGoogle Scholar
  6. 6.
    Shireman PK, McCarthy WJ, Yao JS, Vogelzang RL (1997) Treatment of venous malformations by direct injection with ethanol. J Vasc Surg 26:838–844CrossRefPubMedGoogle Scholar
  7. 7.
    Agus GB, Allegra C, Antignani PL et al (2005) Guidelines for the diagnosis and therapy of the vein and lymphatic disorders. Int Angiol 24:107–168PubMedGoogle Scholar
  8. 8.
    Daya SK, Gowda RM, Gowda MR, Khan IA (2004) Thoracic cystic lymphangioma (cystic hygroma): a chest pain syndrome. Angiology 55:561–564CrossRefPubMedGoogle Scholar
  9. 9.
    Shahriari A, Odell JA (2001) Cervical and thoracic components of multiorgan lymphangiomatosis managed surgically. Ann Thorac Surg 71:694–966CrossRefPubMedGoogle Scholar
  10. 10.
    Papagiannopoulos K, Van Raemdonck DE, De Boeck K, Lerut T (2004) Pediatric thoracic lymph angiomatosis: is chest wall resection too radical? Ann Thorac Surg 77:695–697CrossRefPubMedGoogle Scholar
  11. 11.
    Duman L, Karnak I, Akinci D, Tanyel FC (2006) Extensive cervical-mediastinal cystic lymphatic malformation treated with sclerotherapy in a child with Klippel-Trenaunay syndrome. J Pediatr Surg 41:e21–e24CrossRefPubMedGoogle Scholar
  12. 12.
    Greinwald JH JR, Burke DK, Sato Y et al (1999) Treatment of lymphangiomas in children: an update of Picibanil (OK-432) sclerotherapy. Otolaryngol Head Neck Surg 121:381–387CrossRefPubMedGoogle Scholar
  13. 13.
    Itano H, Lee S, Kulick DM et al (2005) Nontraumatic chest wall systemic-to-pulmonary artery fistula. Ann Thorac Surg 79:e29–e31CrossRefPubMedGoogle Scholar
  14. 14.
    Salo JA, Ketonen PS (1988) Congenital arteriovenous fistulas in the chest wall. Scand J Thorac Cardiovasc Surg 22:7–10PubMedGoogle Scholar
  15. 15.
    Uchida Y, Kawano H, Koide Y et al (2003) Arteriovenous fistula of internal thoracic vessels. Intern Med 42:987–990CrossRefPubMedGoogle Scholar
  16. 16.
    Laurian C, Diner P, Enjolras O et al (1996) Surgical treatment of superficial vascular malformations. Indications for tissue expansion. J Mal Vasc 21:31–35PubMedGoogle Scholar
  17. 17.
    Hartnell GG (1993) Embolization in the treatment of acquired and congenital abnormalities of the heart and thorax. Radiographics 13:1349–1362PubMedGoogle Scholar
  18. 18.
    Yakes WF, Rossi P, Odink H (1996) How I do it. Arteriovenous malformation management. Cardiovasc Intervent Radiol 19:65–71CrossRefPubMedGoogle Scholar
  19. 19.
    Jackson JE, Mansfield AO, Allison DJ (1996) Treatment of high-flow vascular malformations by venous embolization aided by flow occlusion techniques. Cardiovasc Intervent Radiol 19:323–328CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Francesco Stillo
    • 1
  • Giuseppe Bianchini
    • 1
  1. 1.Department of Vascular Surgery, Multidisciplinary Center for Vascular MalformationsIDI, Istituto Dermopatico dell’ImmacolataRomeItaly

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