Angiomas are highly heterogeneous lesions caused by the abnormal development of vessels. They may involve arteries, veins, capillaries or lymphatics, separately or in combination.
Current classification distinguishes vascular tumors (characterized by proliferation of otherwise normal vessels) from vascular malformations (characterized by proliferation of poorly developed vessels).
Vascular tumors are essentially represented by infantile hemangioma, the most important in terms of frequency; but alongside this infantile hemangioma there are other vascular tumors such as congenital hemangiomas, tufted angioma and kaposiform hemangioendothelioma.
Vascular malformations can involve capillaries, which are the origin of planar angiomas, veins, which give rise to venous malformations formerly known as venous angiomas, and lymphatics, which are responsible for lymphatic malformations classically known as lymphangiomas, which are most often cystic. Vascular malformations can develop at the expense of the arteries, giving rise to the dreaded arteriovenous malformations. Capillary, venous and lymphatic malformations are slow-flowing, whereas arteriovenous malformations are fast-flowing, with severe evolutionary potential. Each of these malformations corresponds to a specific clinical picture, with precise complementary examinations and appropriate treatment.
There are complex, combined vascular malformations that may combine capillary, venous, lymphatic and arterial disorders, such as: capillary-venous-lymphatic malformations (formerly Klippel-Trénaunay syndrome), capillary-arterial-venous malformations (formerly Parkes-Weber syndrome). This classification is essential, since each type of anomaly corresponds to an appropriate diagnostic and therapeutic approach.
Functional and morphological imaging have become fundamental to their management, thanks to advances in Doppler ultrasound, CT, MRI and arteriography.
Depending on the diagnosis, the surgeon will opt for abstention, radio-interventional treatment or surgery first, as well as ways of preventing complications.
