Center of Congenital Vascular Anomalies
Center of Congenital Vascular Anomalies

The Center is the only place for the diagnosis, treatment, training and research of congenital vascular diseases in Lithuania and the Baltic States. We provide services for Lithuanian and foreign patients with congenital vascular diseases.

Congenital vascular abnormalities are congenital defects of blood vessels (arteries, veins, lymphatics, capillaries) that can occur at various stages of life (from birth to old age). These diseases are rare and very diverse, can damage any part of the body or an organ. Their clinical manifestation can range from limited derivatives to very widespread forms, from asymptomatic to life-threatening conditions.

The Center of Congenital Vascular Anomalies treats a very wide range of congenital vascular anomalies.

There are two main forms of congenital vascular anomalies (CVA):

Vascular malformations:

  • Arterial
  • Venous
  • Arteriovenous
  • Lymphatic
  • Capillary
  • Combined (venous-arteriovenous, venous-arteriovenous-lymphatic, venous-lymphatic-capillary, venous-arteriovenous-lymphatic-capillary, etc.).
  • Syndrome forms (when CVA is associated with other congenital defects).

Vascular tumors:

  • Most commonly infantile hemangioma,
  • Uncommon - congenital haemangioma,
  • Other rare vascular tumors (caposiform hemangioendothelioma, epitheloid hemangioma, pyogenic granuloma, etc.).

The two pathologies are often confused with each other, although their etiology, pathogenesis, developmental course, and treatment tactics differ greatly. Therefore, a good diagnosis is necessary to apply the right treatment.

Assessing the diversity of CVA in terms of both onset, localization, and symptomatology and age, its diagnostic and treatment process can only be successful with the participation of a multidisciplinary team. The disease can progress throughout life, so constant monitoring of the patient and constant staged or repeated treatment is necessary.

The Center of Congenital Vascular Anomalies at VUH Santara Clinics was established on June 25, 2012. The team of the center at that time consisted of doctors: vascular surgeons, pediatric surgeons, dermatovenereologists, cardiologists, radiologists and interventional radiologists, ophthalmologists, geneticists, plastic reconstruction surgeons, pediatric surgeons, orthopedists-traumatologists. Center coordinator - dr. Birutė Vaišnytė.

Over the last 8 years, new specialists have joined the team: urologists, abdominal surgeons, chest surgeons, hematologists, neonatologists, psychologists, social workers. In this way, the possibilities for the diagnosis and treatment of congenital vascular anomalies have expanded.

The Center provides a wide range of outpatient and inpatient services. We offer consultations of all specialists necessary for the diagnosis and treatment of rare vascular pathologies: vascular surgeons, pediatric surgeons, dermatologists, orthopedists, geneticists, neurosurgeons, maxillofacial surgeons, plastic surgeons, radiologists, cardiologists, pathologists, cardiologists, cardiologists, cardiologists, cardiologists, ophthalmologists, otorhinolaryngologists, hematologists, obstetricians-gynecologists, neonatologists, rehabilitators, psychologists, and social workers.

The Center uses the most advanced diagnostic and treatment technologies: dynamic contrast magnetic resonance angiography (DCE-MRA) - for the diagnosis and differential diagnosis of vascular abnormalities, post-treatment control; transarterial perfusion pulmonary scintigraphy (TLPS) - for the assessment of arteriovenous drainage in arteriovenous malformations, interventional angiography, computed tomography angiography (CTA), vascular double scanning, genetic testing, complex surgical operations for highly spread intravascular arteriovenous malformations, intramuscular malformations, endovascular treatment of congenital vascular abnormalities, combined surgical and endovascular treatment, laser therapy. We provide psychological and social assistance for patients. In this center, patients of all ages are treated and monitored throughout their lives.

Features
The Center of Congenital Vascular Anomalies (CCVA) uses state-of-the-art methods of diagnosis and treatment of congenital vascular anomalies (CVA) - dynamic contrast magnetic resonance angiography (DCE-MRTA), combining sophisticated endovascular and surgical therapies.
 
In 2011, for the first time in Lithuania, transarterial perfusion pulmonary scintigraphy (TPPS) was installed in the Center for the diagnosis of congenital arteriovenous malformations by measuring arteriovenous drainage through malformed tissues. The TPPS test not only helps to diagnose arteriovenous hemorrhage very accurately but based on this, the treatment tactics are selected and the further course of malformation is predicted. This method is performed only in world-class CVA treatment centers. TPPS testing for CVA diagnostics is not performed in other Lithuanian hospitals, as well as in other Baltic or Scandinavian countries. Reports and printed papers prepared by the specialists of the Center of Congenital Vascular Anomalies in Santara Clinics are quoted on this issue at the CVA Diagnostic and Treatment Congresses.
 
Dynamic contrast magnetic resonance angiography for CVA examination is also applied in Lithuania and the Baltic States only in VUH Santara Clinics. Surgical and combined therapy methods (endovascular and surgical combined) are used here and their results are published at the global ISSVA and vascular surgeon conferences in the USA, European countries, Australia, South America, Canada.
 
Papers on diagnostics and treatment of CVA have been presented at global conferences in Boston, New York (USA), Melbourne (Australia), Buenos Aires (Argentina), Vancouver (Canada), Malmö (Sweden), Amsterdam (Netherlands) and others.
 
Highly spread intramuscular malformations in functionally dangerous places have been successfully operated in CCVA Center. The results of which have been announced at world conferences. Complicated, life-threatening forms of CVA are treated with endoscopic laser therapy.
 
The CVA Competence Center at VUH Santara Clinics has long been known for its work among the most prominent ISSVA specialists, therefore in 2016 the specialists of the Center were invited to participate in the International e-Delphi consensus study OVAMA (Outcome measures for Vascular Malformations) research project. Such international activities allow not only to take over but also to contribute to the formation of international good practice in the field of CVA.
 
The activities of the CCVA Center are inseparable from the activities of Vilnius University: research and training are carried out here, including university and postgraduate studies at all levels, improvement courses and other teaching activities, conferences, seminars, and congresses are organized. All this guarantees the dissemination, continuity, and continuous progress of knowledge and expertise.
 
The CCVA Center provides comprehensive diagnostic and treatment services to all Lithuanian residents diagnosed with CVA, starting with neonatal consultations and continuing monitoring and treatment at all stages of life. In some cases, patients from other countries (England, Finland, Ireland, Russia, Sweden, Norway, Denmark, Latvia) are monitored and treated. There are over 2,000 people in the patient monitoring system of the Center. Up to 700 patients are consulted per year. The center has developed a unique monitoring system that collects data on newly diagnosed cases, monitors the course of the disease and evaluates the effectiveness of treatment. The data collected in it is analyzed and constantly updated.
 
Over 100 operations are performed and endovascular treatment methods are applied, clinical, biochemical, microbiological, immunological and genetic, histological examinations are performed, advanced disease detection methods and radiological diagnostics are applied.
 
VUH Santara Clinics carries out international and national scientific projects in the field of CVA, the results of which have been published in many prestigious foreign scientific journals and recognized Lithuanian scientific publications (see attached PDF document down below), as well as summarized in the doctoral dissertation (B. Vaišnytė, Endovascular and surgical treatment of congenital arteriovenous malformations results). A new scientific project is underway: biomolecular studies of vascular malformations, the data of which have been published at world conferences.
 
The CCVA Santara Clinics Center currently employs doctors of various specialties. Depending on the localization and spread of the pathology, patients are thoroughly examined, appropriate specialists are consulted, joint meetings and councils are organized, and patients are often operated on with the participation of surgeons of various specialties.
 
The CVA Center prioritizes the development of biomedical research that promotes medical innovation, and patients are the first to receive new advanced treatments for congenital vascular diseases. We organize and develop epidemiological studies of treatment outcomes and continuously improve treatment protocols based on the principles of evidence-based medicine.
 
The doctors of the center regularly participate in international conferences, they update their knowledge and present the results of research conducted at the center. The Center actively participates in the International Society for the Study of Vascular Anomalies (ISSVA), organizes scientific-practical conferences for students, residents, doctors and patients, cooperates with foreign clinics and centers in Germany, Italy, USA, teaches VU students, residents, specialist doctors.

Dissertations: 

  1. B. Vaišnytė. Įgimtų arterioveninių malformacijų endovaskulinio ir chirurginio gydymo rezultatai (2012).
  2. G. Pošiūnas. Gydymo ilgo pulso Nd:YAG lazeriu įtakos įgimtų hemangiomų vystymuisi palyginamosios studijos įvertinimas. 
  3. A. Strumila. Vaikų hemangiomų prognozės ir gydymo veiksmingumo vertinimas infraraudonųjų spindulių termografija (2018).

International research:

  1. International e-Delphi consensus study OVAMA (Outcome measures for Vascular Malformations) research project. B. Vaišnytė. 
  2. Evaluation of a comparative study of the influence of long pulse Nd: YAG laser treatment on the development of congenital hemangiomas. G. Pošiūnas 2013-2017. 
  3. Biomolecular studies of vascular malformations. A. Kielaitė-Gulla, D. Bironaitė, B. Vaišnytė.

Congenital vascular malformation before treatment (left) and after combined endovascular and surgical treatment and plastic surgery (right).

Angiographic image of congenital vascular malformation before treatment (left 1,2), after treatment (right).



Last edited: 2021-02-07
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