Abstract

Introduction: Congenital Vascular Malformation (CVM) is a benign vascular tumour that results from arrest in the embryogenesis of vessel formation. Multimodal therapy is advocated in the management of CVM, from radiological embolization to surgical excision. It has been proposed that ‘surgically accessible’ lesions managed with complete excision may provide optimum results with least recurrence. We present our surgical experience in such patients at a single centre in North India. Methods: Patients presenting with clinical CVM were evaluated with duplex ultrasound/ Magnetic Resonance Imaging scan to confirm diagnosis and assess extent. They were counselled about natural history of disease and treatment options. Localised lesions suitable for R0 resection with minimum residual disability/cosmetic disfigurement were counselled for excision. Records of patients undergoing surgery from March 2022 to October 2024 were accessed and analysed for demographic details, clinical presentation, any complications, histological diagnosis and recurrence. Results: Eleven patients underwent excision biopsy of CVM at a new semi-urban setup over two years, out of total of 45 patients who presented in study period. A female preponderance was noted (8/11). The mean age of presentation was 29 years (SD 13.0, range 10-53). Suprapatellar bursa was breached inadvertently during excision of a vastus medialis CVM. One patient developed superficial surgical site infection. There were no recurrences over a median follow-up of 12 months (range 1-24 months). Conclusion: Individualized decision for CVM is advocated. In the modern era of minimally invasive surgical procedure preference, complete surgical resection of CVM in selected patients can provide recurrence free treatment.

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