| Abstract [eng] |
Introduction. Intraosseous congenital vascular malformations are rare pathological formations that develop due to vascular developmental disorders in bone tissue during embryogenesis. These malformations can be arteriovenous, venous, lymphatic, or mixed in origin. While soft tissue vascular malformations have been extensively studied, intraosseous malformations remain insufficiently investigated and are often misdiagnosed. Aim of the study. To analyze the treatment methods of intraosseous congenital vascular malformations, their effectiveness, and application to different types of malformations. Objectives. 1) To review the classification, pathogenesis, and clinical course of intraosseous vascular malformations; 2) to analyze the diagnostic and treatment peculiarities of intraosseous congenital arteriovenous and venous malformations; 3) to analyze three clinical cases of intraosseous congenital vascular malformations, evaluating the effectiveness of applied treatment methods. Research methods. A literature review was conducted using PubMed and Google Scholar databases. Three clinical cases diagnosed and treated at the Vilnius University Hospital Santaros Klinikos Center for Congenital Vascular Anomalies were analyzed. Results. Literature often emphasizes the importance of bone resection; however, clinical cases have revealed that intraosseous spread is usually associated with congenital vascular malformation of the surrounding soft tissues, and treatment outcomes depend on the correction of this component. In arteriovenous malformation treatment, embolization shows 88% effectiveness, but the recurrence rate reaches up to 98% over five years. For venous malformations, the most effective method is complete removal of the affected bone part, after which the risk of recurrence is minimal. Analysis of three clinical cases showed different treatment outcomes: in the first case, good results were achieved after surgical treatment; in the second case, the disease progressed to gangrene requiring amputation; in the third case, only partial results were achieved despite multiple surgical interventions. Conclusions. MRA and ultrasound examinations are essential for the diagnosis of intraosseous vascular malformations. Surgical treatment remains the most important method, often combined with embolization or sclerotherapy. Clinical case analysis confirms that treatment success depends more on the management of extraosseous pathology rather than just bone resection. Patients must be monitored long-term due to the risk of recurrence. |
