NYU Langone is home to one of the largest teams of vascular specialists in the country. They treat a high volume of people with many types of vascular malformations in the chest, abdomen, pelvis, arms, and legs.
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Our experts are skilled at determining which surgical approach may best alleviate your symptoms, and whether watchful waiting—in which doctors monitor the malformation over time to see if symptoms change—may be more appropriate.
No surgery is without risk, and some vascular malformations are best left alone based on their size and location. If your NYU Langone doctor advises against surgery, he or she monitors you closely with diagnostic testing and through regular physical exams.
Before considering surgery for a vascular malformation, your doctor reviews your imaging test results to determine if the malformation has bled or is at risk of bleeding. These test results can also reveal if the malformation is small enough and is located in an area of the body where it can be surgically removed.
When surgery is recommended, the goal is to prevent or stop the malformation from compressing organs or nerves, which may cause pain, or to stop bleeding. Doctors also address any related pelvic pressure or swelling in the arms and legs.
If your doctor considers surgery to be the best treatment for a vascular malformation, he or she discusses all possible complications and recovery times with you in detail prior to the procedure.
The type of surgery your doctor performs depends on the location, size, and features of the vascular malformation. Any procedure is usually performed with general anesthesia.
Endovascular surgery, also called embolization, is a minimally invasive technique used to block blood flow to a vascular malformation, shrinking it rather than completely removing it. Our specialists perform endovascular surgery for arteriovenous malformations when a conventional procedure could damage the surrounding tissue. This technique is also used to make conventional surgery safer, reducing the risk of bleeding.
During endovascular surgery, a surgeon guides a catheter through the arteries until it reaches the cluster of blood vessels that comprise the malformation. Next, he or she delivers special medical adhesives, tiny manmade particles called microspheres, or polymerizing glue through the catheter and into the artery. These materials work to fill the vessels and block blood flow.
Most people stay overnight in the hospital to monitor for bleeding and return home the next day.
Conventional, or “open,” surgery offers the most thorough treatment for vascular malformations of the torso and limbs, because allows doctors to remove a malformation altogether. It’s generally performed only on small or easy-to-reach malformations, such as those in the arms or legs, where removal is not likely to cause other serious complications.
Although surgery can be helpful in alleviating symptoms, it is usually difficult for surgeons to completely remove vascular malformations because there is a risk of bleeding and damage to nearby organs. As a result, some malformations return and may require additional treatment 10 to 15 years later.
With or without surgery, all vascular malformations require long-term monitoring. Hormone changes from puberty, pregnancy, and menopause can cause a malformation to grow.
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