Pelvic Vascular Malformations

Chapter

Abstract

The pelvis can be divided into the pelvic cavity and gluteal area. Pelvic truncular vascular anomalies include aplasia, hypoplasia or aneurysm of iliac arteries, and aplasia or hypoplasia of cava iliac veins. Treatment is rarely required except for aneurysm of the sciatic artery. Pelvic cavity venous malformations may involve the organs, like the rectum, bladder, uterus, etc. Genital location, like the labia majora in females and the penis in males, is possible. Preferred treatment is alcohol or foam sclerosis. Arteriovenous malformations of the pelvis are mainly treated by embolization. Pelvic lymphatic dysplasia is treated mainly by sclerosis with alcohol, Picibanil, and other substances. Gluteal venous and lymphatic malformations, which may be limited or infiltrating, can be treated best by alcohol sclerosis. Gluteal AVM is treated by embolization.

Keywords

Pelvic Vascular Arteriovenous Malformations Genital Venous Malformations Pelvic Venous Malformations pelvic lymphatic malformations 
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References

  1. 1.
    Servelle M, Bastin R, Loygue J et al (1976) Hematuria and rectal bleeding in the child with Klippel and Trenaunay syndrome. Ann Surg 183(4):418–428CrossRefPubMedCentralPubMedGoogle Scholar
  2. 2.
    Azizkhan RG (1991) Life-threatening hematochezia from a rectosigmoid vascular malformation in Klippel-Trenaunay syndrome: long-term palliation using an argon laser. J Pediatr Surg 26:1125–1128CrossRefPubMedGoogle Scholar
  3. 3.
    Gandolfi L, Rossi A, Stasi G et al (1987) The Klippel-Trenaunay syndrome with colonic hemangioma. Gastrointest Endosc 33:442–445CrossRefPubMedGoogle Scholar
  4. 4.
    Tamisier D, Melki JP, Cormier JM (1990) Congenital anomalies of the external iliac artery: case report and review of the literature. Ann Vasc Surg 4:510–514CrossRefPubMedGoogle Scholar
  5. 5.
    Santaolalla V, Bernabe MH, Hipola Ulecia JM, De Loyola Agundez Gomez I, Hoyos YG, Otero FJ, Mendizabal RF, Maldonado FJ, Legrand JL (2010) Persistent sciatic artery. Ann Vasc Surg 24(5):691CrossRefPubMedGoogle Scholar
  6. 6.
    Knight BC, Tait WF (2010) Massive aneurysm in a persistent sciatic artery. Ann Vasc Surg 24(8):1135.e13–8CrossRefGoogle Scholar
  7. 7.
    Tonnessen BH, Sternbergh WC 3rd, Mannava K, Money SR (2007) Endovascular repair of an iliac artery aneurysm in a patient with Ehlers-Danlos syndrome type IV. J Vasc Surg 45(1):177–179CrossRefPubMedGoogle Scholar
  8. 8.
    Chee YL, Cullighan DJ, Watson HG (2001) Inferior vena cava malformations as a risk factor for deep venous thrombosis in the young. Br J Haematol 114:878–880CrossRefPubMedGoogle Scholar
  9. 9.
    D’Aloia A, Faggiano P, Fiorina C et al (2003) Absence of inferior vena cava as a rare cause of deep venous thrombosis complicated by liver and lung embolism. Int J Cardiol 88:327–329CrossRefPubMedGoogle Scholar
  10. 10.
    Ruggeri M, Tosetto A, Castaman G, Rodeghiero F (2001) Congenital absence of the inferior vena cava: a rare risk factor for idiopathic deep-vein thrombosis. Lancet 357:441CrossRefPubMedGoogle Scholar
  11. 11.
    Pop S, Opincaru I (2012) Anomalies of the inferior vena cava in patients with deep venous thrombosis. Pictorial essay. Med Ultrason 14(1):53–59PubMedGoogle Scholar
  12. 12.
    Malaki M, Willis AP, Jones RG (2012) Congenital anomalies of the inferior vena cava. Clin Radiol 67:165–171CrossRefPubMedGoogle Scholar
  13. 13.
    Kutsai A, Lampros TD, Cobanogku A (1999) Right iliac vein agenesis, varicosities and widespread hemangiomas: report of a rare case. Tex Heart Inst J 26(2):149–151Google Scholar
  14. 14.
    Onkar D, Onkar P, Mitra K (2013) Isolated bilateral external iliac vein aplasia. Surg Radiol Anat 35(1):85–87CrossRefPubMedGoogle Scholar
  15. 15.
    Ganguli S, Kalva S, Oklu R, Walker TG, Datta N, Grabowski EF, Wicky S (2012) Efficacy of lower-extremity venous thrombolysis in the setting of congenital absence or atresia of the inferior vena cava. Cardiovasc Intervent Radiol 35(5):1053–1058CrossRefPubMedGoogle Scholar
  16. 16.
    Sagban TA, Grotemeyer D, Balzer KM et al (2010) Surgical treatment for agenesis of the vena cava: a single-centre experience in 15 cases. Eur J Vasc Endovasc Surg 40(2):241–245CrossRefPubMedGoogle Scholar
  17. 17.
    Herman AR, Morello F, Strickland JL (2004) Vulvar venous malformations in an 11-year-old girl: a case report. J Pediatr Adolesc Gynecol 17(3):179–181CrossRefPubMedGoogle Scholar
  18. 18.
    Wang S, Lang JH, Zhou HM (2009) Venous malformations of the female lower genital tract. Eur J Obstet Gynecol Reprod Biol 145(2):205–208CrossRefPubMedGoogle Scholar
  19. 19.
    Gerald HJ, Steven MS, Charles JD (1997) Surgery of the penis and urethra. In: Patrick CW, Alan BRE, Darracott V Jr, Alan JW (eds) Campbell’s urology, 7th edn. Saunders, Philadelphia, 3: 3327Google Scholar
  20. 20.
    Fioramonti P, Maruccia M, Ruggieri M, Onesti MG (2013) A rare case of lymphangioma in the gluteal region: surgical treatment combined with sclerotherapy and laser therapy. Aesthetic Plast Surg 37(5):960–964CrossRefPubMedGoogle Scholar
  21. 21.
    Burrows P (2008) Vascular malformations involving the female pelvis. Semin Intervent Radiol 25(4):347–360CrossRefPubMedCentralPubMedGoogle Scholar
  22. 22.
    Patel RC, Zynger DL, Laskin WB (2009) Blue rubber bleb nevus syndrome: novel lymphangiomatosis-like growth pattern within the uterus and immunohistochemical analysis. Hum Pathol 40(3):413–417CrossRefPubMedGoogle Scholar
  23. 23.
    Laor T, Burrows PE (1998) Review congenital anomalies and vascular birthmarks of the lower extremities. Magn Reson Imaging Clin N Am 6(3):497–519PubMedGoogle Scholar
  24. 24.
    Ashour MA, Soliman HE, Khougeer GA (2007) Role of descending venography and endovenous embolization in treatment of females with lower extremity varicose veins, vulvar and posterior thigh varices. Saudi Med J 28(2):206–212PubMedGoogle Scholar
  25. 25.
    Pul-M P-N (1995) Cavernous haemangioma of the penis in an infant. Int Urol Nephrol 27:113–115CrossRefPubMedGoogle Scholar
  26. 26.
    Keljo DJ, Yakes WF, Andersen JM, Timmons CF (1996) Recognition and treatment of venous malformations of the rectum. J Pediatr Gastroenterol Nutr 23(4):442–446CrossRefPubMedGoogle Scholar
  27. 27.
    Fishman SJ, Shamberger RC, Fox VL, Burrows PE (2000) Endorectal pull-through abates gastrointestinal hemorrhage from colorectal venous malformations. J Pediatr Surg 35(6):982–984CrossRefPubMedGoogle Scholar
  28. 28.
    Wilson C, Wong Kee Song LM, Chua H, Ferrara M et al (2001) Bleeding from cavernous angiomatosis of the rectum in Klippel-Trénaunay syndrome: report of three cases and literature review. Am J Gastroenterol 96:2783–2788PubMedGoogle Scholar
  29. 29.
    Hayakawa H, Kusagawa M, Takahashi H et al (1998) Arteriovenous malformation of the rectum: report of a case. Surg Today 28(11):1182–1187CrossRefPubMedGoogle Scholar
  30. 30.
    Manolitsas T, Hurley V, Gilford E (1994) Uterine arteriovenous malformation–a rare cause of uterine haemorrhage. Aust N Z J Obstet Gynaecol 34(2):197–199CrossRefPubMedGoogle Scholar
  31. 31.
    Jain K, Fogata M (2007) Retained products of conception mimicking a large endometrial AVM: complete resolution following spontaneous abortion. J Clin Ultrasound 35(1):42–47CrossRefPubMedGoogle Scholar
  32. 32.
    Mortensen JD, Ellsworth HS (1965) Internal iliac arteriovenous fistula developing postpartum. Am J Cardiol 16(2):292–296CrossRefPubMedGoogle Scholar
  33. 33.
    Singh N, Tripathi R, Mala YM, Tyagi S, Singh C (2014) Varied presentation of uterine arteriovenous malformations and their management by uterine artery embolization. J Obstet Gynaecol 34(1):104–106CrossRefPubMedGoogle Scholar
  34. 34.
    Delotte J, Chevallier P, Benoit B, Castillon JM, Bongain A (2006) Pregnancy after embolization therapy for uterine arteriovenous malformation. Fertil Steril 85(1):228CrossRefPubMedGoogle Scholar
  35. 35.
    Houbballah R, Mallios A, Poussier B, Soury P, Fukui S, Gigou F, Laurian C (2010) A new therapeutic approach to congenital pelvic arteriovenous malformations. Ann Vasc Surg 24(8):1102–1109CrossRefPubMedGoogle Scholar
  36. 36.
    Do YS, Kim YW, Park KB, Kim DI, Park HS, Cho SK, Shin SW, Park YJ (2012) Endovascular treatment combined with emboloscleorotherapy for pelvic arteriovenous malformations. J Vasc Surg 55(2):465–471CrossRefPubMedGoogle Scholar
  37. 37.
    Calligaro KD, Sedlacek TV, Savarese RP, Carneval P, DeLaurentis DA (1992) Congenital pelvic arteriovenous malformations: long-term follow-up in two cases and a review of the literature. J Vasc Surg 16(1):100–108CrossRefPubMedGoogle Scholar
  38. 38.
    Huang KS, Wang NL, Liu YP (2010) Cystic lymphatic malformation of the pelvis mimicking seminal vesicle cysts. J Pediatr Surg 45(7):1559–1561CrossRefPubMedGoogle Scholar
  39. 39.
    Kumar S, Sarkar D, Prasad S, Gupta V, Ghosala P, Kaman L, Yadav TD, Ganesamoni R, Singh SK (2012) Large pelvic masses of obscure origin: urologist’s perspective. Urol Int 88(2):215–224CrossRefPubMedGoogle Scholar
  40. 40.
    Häcker A, Hatzinger M, Grobholz R, Alken P, Hoang-Böhm J (2006) Scrotal lymphangioma–a rare cause of acute scrotal pain in childhood. Aktuelle Urol 37(6):445–448CrossRefPubMedGoogle Scholar
  41. 41.
    Niu ZB, Hou Y, Sun RG, Chen H, Yang Y (2011) Cystic lymphatic malformation of bladder presenting as a pelvic mass. J Pediatr Surg 46(6):1284–1287CrossRefPubMedGoogle Scholar
  42. 42.
    Burrows PE, Mason KP (2004) Review: percutaneous treatment of low flow vascular malformations. J Vasc Interv Radiol 15(5):431–445CrossRefPubMedGoogle Scholar
  43. 43.
    Yakes WF (1994) Extremity venous malformations: diagnosis and management. Semin Intervent Radiol 11:332–339CrossRefGoogle Scholar
  44. 44.
    Donnelly LF, Bissett GS III, Adams D (1999) Combined sonographic and fluoroscopic guidance: a modified technique for percutaneous sclerosis of low-flow vascular malformations. AJR Am J Roentgenol 173(3):655–657CrossRefPubMedGoogle Scholar
  45. 45.
    Ishihara T, Hirooka M, Ono T (1997) Arteriovenous malformation in the buttock: treatment with a combination of selective embolization and excision. J Dermatol 24(12):787–792CrossRefPubMedGoogle Scholar
  46. 46.
    Chien JH, Lee TP, Wang CW, Chen SL, Lin CH (2010) Intramuscular arteriovenous malformation of the gluteus maximus muscle. J Med Sci 30(5):225–229Google Scholar
  47. 47.
    Malan E (1974) Vascular malformations (Angiodysplasias). Carlo Erba Foundation, MilanGoogle Scholar
  48. 48.
    Loose DA, Faerber G, Weber J (2013) Primäre Varikose und venöse Malformation im Genitalbereich. Phlebologie 5:275–282CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2015

Authors and Affiliations

  1. 1.Department of Vascular SurgeryCenter for Vascular Malformations “Stefan Belov,” Clinical Institute Humanitas “Mater Domini”Castellanza (Varese)Italy
  2. 2.Deparment of Vascular SurgeryA.O.G. Salvini HospitalGarbagnate MilaneseItaly

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