The role of surgery in the management of congenital vascular anomalies.

Surgery is one of the modalities used to treat vascular lesions. Its role is to act in concert with interventional radiology and the various pharmacologic agents. The role of surgery in patients with hemangiomas is limited to nonresponders to propranolol, complications, and eyelid lesions. Corrective surgery would also normalize facial distortion and asymmetry which may result from a hemangioma. Concerning vascular malformations, cure may only be obtained in case of small, focal lesions. In larger, extensive lesions, the role of surgery is limited to debulking the mass. This is usually performed after preoperative embolization or sclerotherapy to reduce the amount of intraoperative blood loss. Surgery is usually not curative but would decrease the amount of disease needing to be sclerosed. Surgery is therefore most often an adjuvant therapy.