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New imaging techniques avoid unnecessary diagnostic tests for Klippel-Trénaunay vascular malformation

The use of multislice computed tomography (CT) - a latest generation scanner – or of magnetic resonance (MR) in the diagnosis of a vascular malformation of congenital origin – a syndrome known as Klippel-Trénaunay, avoids the patient being subjected to a series of tests and this saves time and provides greater efficacy in treatment. The reason for these advantages lies in the fact that both imaging techniques enable an overall evaluation of the Klippel-Trénaunay syndrome. More specifically, the administration of an intravenous contrast agent (angio-CT, angio-MR) enables the diagnosis and efficient determination of the origin and extent of the congenital vascular malformation typical of this syndrome. All this is outlined in an article by specialists at the University Hospital of the University of Navarre, recently published in the internationally-renowned journal specialising in dermatology, Journal of American Academy of Dermatology.

Doctor Pedro Redondo Bellón, member of the Department of Dermatology at ther Navarre university clinic and Doctor Gorka Bastarrika Alemañ from the Department of Radiology, describe the Klippel-Trénaunay syndrome as a vascular malformation that affects the limbs and manifests itself in the form of a “Port wine” stain. It is caused by a series of large dilations of (blood) vessels which form a complex knotted ball. The syndrome causes an increase in the size of the limb at the expense of bone and soft tissues. Incidence is one in every 30,000 newborn babies.

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Avoiding tests and saving time

To analyse the extent of the ailment and draw up the diagnosis, in collaboration with the Radiology service, two non-intrusive techniques have been applied in a novel manner - the angio-CT y and the angio-MR, which, to date, have not been used to these ends.

By means of the two radiological procedures, the patient being subjected to a battery of tests is avoided – the ecography, the magnetic resonance, simple radiographies and conventional angiographies (intrusive studies of arteriography or flebography). Now, with just one test, an overall visualisation of the affected limb can be effected. The angio-CT or the angio-MR provide the doctor with information on the size of the limb as well as showing the vascular anomalies of the patient (the connections between the vessels and the existence or otherwise of a deep venous system, amongst other fundamental aspects) in order to evaluate the illness.

For the exploration of Klippel-Trénaunay syndrome, the angio-CT is initially used, except with paediatric patients, where the use of angio-MR is recommended due to its lack of radiation. The end-result information provided by both diagnostic techniques is similar and so it is probable that, in the near future and with advances in MR, this technique will also be used with adults.

Treatment with microfoam

The reference treatment used with patients suffering from Klippel-Trénaunay syndrome at the University Hospital of the University of Navarre involves the injection of polydocanol microfoam, a novel procedure applied in a general way for treating varicose veins and, more specifically, for certain vascular malformations.

This treatment, also known as flebosclerosis with microfoam, enables the elimination of anomalous veins of practically all calibres – while avoiding surgery. This study of the administration of treatment with microfoam in patients with Klippel-Trénaunay syndrome is subsidised by the Government of Navarre. It should also be pointed out that, for five years now, University Hospital has been using sclerotherapy with persons affected by vascular malformations.