Venous malformations: what do phleboliths tell us in the pediatric population?

Pediatr Surg Int. 2022 Oct;38(10):1501-1506. doi: 10.1007/s00383-022-05181-4. Epub 2022 Jul 19.

Abstract

Purpose: Phleboliths are often observed within Venous malformations (VM) and frequently indicated as cause of morbidity. The aim of this study is to investigate independent risk factors for phleboliths in a pediatric population and to determine if its presence influences clinical management.

Methods: We retrospectively review data from patients diagnosed with VM in a vascular anomalies center during a 5-year period. Associations between phleboliths and potential risk factors were assessed. A multivariable analysis, was performed to assess the influence of phleboliths in the need for surgery.

Results: We included 88 patients with a mean age of 10 years. Phleboliths were found in 33.0%. In univariate analysis, there were no significant differences between the two groups regarding age or gender, location, dimension or depth of the VM, pain and laboratory parameters. Multivariable analysis could not detect any independent risk factor for phleboliths. In contrast, multivariable logistic analysis revealed that when phleboliths were present, the need for surgical extirpation was more likely (p = 0.031).

Conclusions: This study showed that patients who have phleboliths within their VM seem to require surgery more frequently. This constitutes an entirely innovative thought that could raise awareness to a lower threshold for surgery in this group of patients.

Keywords: Children; Phleboliths; Venous malformation.

MeSH terms

  • Child
  • Developmental Disabilities
  • Humans
  • Pain
  • Retrospective Studies
  • Risk Factors
  • Vascular Malformations* / diagnosis
  • Vascular Malformations* / epidemiology