Miraculous efficacy of minimally invasive interventions in hemangioma

In November 2009, a 9-year-old child with an egg-sized and progressively enlarging hemangioma on his right upper arm was seen in our oncology interventional ward. After careful analysis of his condition by the ward director, Lei Yu, an angiogram was performed in time to clarify the diagnosis, and he was treated with percutaneous injection of sclerosing agent to destroy the blood vessels, resulting in a significant reduction of the tumor and was discharged. Recently, the child returned to the hospital again under the leadership of her father for a follow-up consultation, and the once obviously elevated hemangioma had become flat and did not show any abnormality like the surrounding normal skin. The little girl, who used to have low self-esteem, quietly came close to Director Yu Lei’s ear and said, “Uncle Yu, I can finally wear a beautiful camisole in the summer, so I don’t have to worry about children laughing at me. The girl’s father also thanked Director Yu, saying that the interventional approach was good, minimally invasive, effective and scarless. Vascular malformation is a common disease that can occur in the head, face, limbs, subcutaneous, muscle, skeletal muscle, manifested as trapezoid hemangioma, cavernous hemangioma and arteriovenous malformation, etc., in life affect the aesthetic and motor ability. They can also occur in other parts of the body, such as cavernous hemangioma of the liver, which may cause swelling and pain in the liver area due to progressive enlargement of the tumor, or in severe cases, rupture and bleeding, resulting in life-threatening injuries. For arteriovenous malformations in the skull and spinal cord, a small amount of rupture and bleeding can lead to life-threatening, hemiplegic or paraplegic conditions due to the specific location. Therefore, vascular malformations should not be taken lightly. Currently, Doppler ultrasound, CT, and MRI all have different advantages in the diagnosis of vascular malformations. However, the “gold standard” for vascular malformations is angiography (DSA), which not only clearly shows the blood supplying arteries and returning veins, but also reflects the degree of abnormal anastomosis between the arteries and veins, and allows simultaneous implementation of embolization therapy based on the results of the examination. In the treatment of vascular malformations, surgical resection has been preferred in the past, but most of the vascular malformations are deeper and invade more widely, so it is often difficult to remove them cleanly, and they are prone to recurrence after surgery, and there can be hemorrhage during surgery, etc. For vascular malformations in special areas including intracranial and spinal cord, the clinical application is greatly restricted because of the difficulty of surgery, many postoperative complications, and high mortality and disability rates. At present, with the development of technology and new materials, minimally invasive interventional diagnosis and treatment are increasingly valued by clinicians and welcomed by patients. Pre-surgical angiography can clarify the condition of the lesion, and the choice of treatment is determined by the results of the pre-surgical angiography and the comprehensive assessment of the subsequent treatment plan. Currently, percutaneous vascular sclerotherapy with multi-point injection and transfemoral vascular malformations with embolization of the blood supply artery are used in vascular malformations of the extremities. Endovascular interventions are mostly used for vascular malformations of the liver and intracranial and spinal cord, where the blood supply artery of the malformed vessel is reached through a fine catheter and curing treatment with sclerosing agents and liquid glue is used. Only local anesthesia is required, and the patient has no obvious pain during the procedure, and can get out of bed 24 hours after the procedure, and can also be treated in stages if the lesion is extensive. It brings a new hope for the treatment of patients. Hepatic cavernous hemangioma, which used to require surgical resection, has now become the treatment of choice due to the widespread development of interventional embolization techniques. There will no longer be large defects in the liver, heavy intraoperative bleeding, many postoperative complications, slow postoperative recovery, long hospitalization periods, or intolerable conditions for patients. At present, our ward carries out a number of interventional procedures for vascular malformations, including angiographic diagnosis of vascular malformations of the head, face and limbs, cavernous hemangioma of the liver, pre-surgical diagnosis, percutaneous sclerotherapy, and embolization treatment of transfemoral vascular malformations. In terms of professional staffing, the director of the ward, Yu Lei, is the only doctor of interventional specialty in Guangxi, and most of his subordinates are masters of interventional specialty or senior attending physicians who have received full-time training in interventional technology in famous hospitals in China, forming an echelon of skilled interventional talents. We welcome all patients to come for consultation, consultation and treatment.