What Is a Venous Malformation (VM)?
A venous malformation (VM) is a place in the body where veins haven't grown the right way. Veins in a VM tend to be larger and more tangled than normal veins. A VM in the skin usually looks like a maroon, blue, or purple spot.
Kids who have VMs are born with them. A VM might not be visible until later when it has gotten bigger or its veins have stretched. A VM grows as a child grows and may also grow in response to injury or partial removal.
What Are the Signs & Symptoms of a Venous Malformation (VM)?
Kids with VMs may have these symptoms:
- one or more maroon, purple, or bluish spots on the skin
- a bulge in the skin with no unusual color
- a bluish spot on the skin that gets bigger during or after physical activity, bearing down, crying, or positioning the body so that the spot is below heart level
- vision problems
- trouble breathing
- bones that break easily
What Causes Venous Malformations (VM)?
Venous malformations are the most common of all of the vascular malformations (also called vascular anomalies). These are problems that happen when blood vessels (capillaries, arteries, veins, or lymphatic vessels) don't develop as they should.
Most VMs have no clear cause, but some are due to genetic problems and may run in families.
Some rare genetic conditions that include VMs are:
- Blue rubber bleb nevus syndrome (BRBNS): one or more VMs in the skin and the digestive tract
- Glomuvenous malformations (GVMs): bluish nodules that may be painful or sensitive to cold temperatures. GVMs are usually near the fingers and toes, and may run in families.
- Klippel-Trenaunay-Weber syndrome: a complicated disorder with a combination of different vascular anomalies, overgrowths of bone and other tissues, and varicose veins
- Cutaneomucosal venous malformations (also called multiple cutaneous and mucosal venous malformations or VMCM): multiple VMs of the skin and mucous membranes (moist areas of the body, such as the inside of the mouth)
How Is a Venous Malformation (VM) Diagnosed?
A VM is usually diagnosed based on a child's health history, pictures and imaging of the VM, and an examination.
To learn more about how the VM is attached to other blood vessels and to see if internal organs are affected, the doctor may order these imaging tests:
- an ultrasound, to determine the structure and depth of a skin VM
- an MRI, for a 3D picture of the VM and to look for VMs in internal organs
- a CT scan, to create images of VMs affecting bones
How Is a Venous Malformation (VM) Treated?
VMs can be very difficult to treat and often grow back after removal. So a VM is usually treated only if it:
- causes pain or deformity
- harms body functions such as breathing or vision
- causes bleeding that is frequent, hard to stop, or involves internal organs (such as the stomach, liver, or intestines)
Evaluation by a vascular anomaly specialist is recommended for VMs in sensitive areas such as the face, neck, hands, or feet or when VMs affect internal organs.
VM treatment may include doctors from several different specialties and include:
- sclerotherapy: injection of a chemical into a VM to shrink it; usually done by an interventional radiologist (a doctor who specializes in minimally invasive, targeted treatments)
- surgery: an option when the VM is small or in the digestive tract. Complete removal is essential to keep the VM from growing back.
- combined therapy: surgery can be done in combination with sclerotherapy to improve appearance or function
- compression garments: tight-fitting clothing that compresses the VM to reduce swelling, pain, and the potential for injury and bleeding
- cutaneous laser: treatments at the surface of the skin to reduce discoloration
- endovascular laser: a tiny laser fiber inserted into veins of the VM to try to close them. This also may be done by an interventional radiologist.
- medicines: treatment with medicines might be done when other treatments have not been successful, or in combination with sclerotherapy or surgery
VMs tend to get bigger as a child grows. Regular follow-up with your doctor is important.
Research is ongoing for both the treatment of VMs and the prevention of regrowth after treatment. New medicines and genetic research for VMs and other vascular problems are advancing and new treatments might be available in the next few years.