Classification and treatment of intramuscular vascular malformations of extremities / 中国现代普通外科进展

ABSTRACT

Objective:To explore the clinical classification and ideal treatment of extremitalintramuscular vascular malformations. Methods:472 cases of extremital intramuscular vascularmalformations were enrolled from Oct. 1983-Dec. 2004;the clinical manifestations and iconography features were analysed. Thus intramuscular malformations, according to the blood dynamics, areclassified into two types-the high efferent speed of 40 casaes(AVM)and the low efferent speedof 432(VM), while classified into five types according to pathological extent-monlocalized typeof 92 cases, polylocalized 162, extensive type of 166, nerve trunk type of 38 diffuse type of 14 casses operative means 360 patients received operation alone(82 cases with two-stage operation),10 patients received operation plus muscle shift, 34 patients received operation plusembolism of entering arteria, 58 patients received embolism of efferent veins plus intratumorallysclerotherapy, 6 patients received limbs removal. 4 abandoned all treatments. Results: 386 caseswere followed-up from 1 years to 20.Among them, 234 patients were cured(60.62%), 78 cases were valid(20.21%) , 58 cases were improved (15.03%),16 cases were invalid (4.15%) . Conclusion:the right pathological classification is based on reasonable iconography diagnostic course, the new pathological classification contributes to the treatment selection and judgment of the prognosis, comprehensive treatment in which operation taken as a chief means,is a valid way for extremital intramuscular vascular malformations.