Capillary-venule malformation is a microfistulous variant of arteriovenous malformation

J Vasc Surg Venous Lymphat Disord. 2021 Jan;9(1):220-225. doi: 10.1016/j.jvsv.2020.05.012. Epub 2020 May 26.

Abstract

Objective: To describe typical clinical presentation of patients with microfistular, capillary-venule (CV) malformation as a variant form of arteriovenous malformations (AVM).

Methods: A retrospective clinical analysis of 15 patients with CV-AVM confirmed by a computational flow model enrolled in a prospective database of patients with congenital vascular malformation between January 2008 and May 2018.

Results: The mean age of the patients at first time of presentation was 30 years with balanced sex ratio. Presentation was dominated by soft tissue hypertrophy (n = 12 [80.0%]) and atypical varicose veins (n = 11 [73.3%]). The anatomic location of enlarged varicose veins gave no uniform pattern and did not correspond with the typical picture of primary varicose vein disease. Most often, symptomatic CV-AVM was found at the lower extremities in this series of unselected patients. The most frequent compartment affected was the subcutis (n = 14 [93.3%]), involvement of muscle was recorded in one-third and cutis in one-fourth of patients.

Conclusions: A high grade of clinical suspicion is needed to recognize CV-AVM and to prevent inadequate therapy owing to missed diagnosis.

Keywords: Chronic venous disease; Microcirculation; Varicose veins; Vascular malformation; Venous insufficiency.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arteriovenous Malformations* / complications
  • Arteriovenous Malformations* / diagnostic imaging
  • Arteriovenous Malformations* / physiopathology
  • Arteriovenous Malformations* / therapy
  • Blood Flow Velocity
  • Capillaries / abnormalities*
  • Capillaries / diagnostic imaging
  • Capillaries / physiopathology
  • Child
  • Child, Preschool
  • Databases, Factual
  • Female
  • Humans
  • Infant
  • Leg Ulcer / diagnosis
  • Leg Ulcer / etiology
  • Leg Ulcer / physiopathology
  • Male
  • Microcirculation
  • Middle Aged
  • Prognosis
  • Registries
  • Retrospective Studies
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / etiology
  • Varicose Veins / physiopathology
  • Venules / abnormalities*
  • Venules / diagnostic imaging
  • Venules / physiopathology
  • Young Adult