Vascular Malformations (Vascular Birthmarks)

Dr Parsi specialises in the treatment of vascular malformations (vascular birthmarks). These are abnormalities of vasculature that are present since birth and grow proportionate to the person's growth.

Vascular malformations used to get confused with haemangiomas (tumours) and inappropriate treatments were used to treat these lesions. In summary, haemagiomas are tumours which are NOT present at birth and grow rapidly. Most haemangiomas have disappeared  by the time the child in 10 years old. Vascular malformations, by contrast, are permanent and do not go away unless treated.

Vascular malformations are divided into

• Capillary malformations (CM)- these used to be called 'portwine stains'.
• Venous malformations (VM)- these arise from abnormal veins
• Lymphatic malformations (LM)- these arise from abnormal lymphatics
• Arterio-venous malformations (AVM)- these arise from abnormal arteries
• Combined and Complex malformations and syndromes

Complex syndromes including Klippel-Trenaunay syndrome, Parkes Weber syndrome, Maffuci's syndrome and others that have mixed features.

At Sydney Skin and Vein Clinic, we use vaious imaging modalities and in particular vascular ultrasound, angiography and MRI to assess these lesions. Rarely, a biopsy is required to establish the sub-type of the vascular malformation.For example, a glomovenous malformation, previously known as glomangioma, can be differentiated from Blue Rubber Bleb syndrome, by analysing the samples from a biopsy.

At this practice, our Phlebology Vascular Lab is staffed with trained sonographers and equipped with dedicated vascular ultrasound systems with special features to assess vascular birthmarks. Ultrasound and Doppler studies are essential in making a diagnosis and can differentiate between the different types of malformation.

Dr Parsi treats children with a vascular malformation at Sydney Children's Hospital. Most treatments for adult patients are done at Sydney Skin and Vein Clinic. Treatments are minimally invasive and image guided.The lesions are located with vascular ultrasound and accessed using special catheters (lines). The lesion may then be viewed with an image intensifier and a contrast agent may be used to further visalise the image. Depending on the type of the lesion, an embolic or sclerosing agent is then introduced into the lesion that will close off the lesion. For large venous malformations, Dr Parsi uses endovenous laser ablation (EVLA) with a success rate of more than 90%.

At Sydney Children's Hospital, the procedure gets done under general anaesthetic. However, most adult patients get treated at Sydney Skin and Vein Clinic using local anaesthetic (cream and injection).

Patients are required to wear a compression garment or stockings (depending on the site of the lesion) after each treatment and avoid excessive exercise. There will be some swelling and discomfort after the procedure, depending on the agent used for the treatment. Children do not need a full admission to the hospital and are discharged the same day. Adult patients are sent for a walk after the treatment and can go home afterwards.

To see Dr Parsi, you need to be referred by your family doctor or your specialist.