There may be instances when more than one type of tissue is present in a vascular malformation. For example, capillary malformations may be present alongside venous and/or lymphatic malformations. Arteriovenous malformations are another example where abnormal arteries and veins develop together. In fact, there are certain syndromes that can be associated with combined vascular malformations, such as Klippel Trenaunay and Parkes Weber syndromes.
Combined malformations are typically much more complex than their isolated counterparts. Multiple treatment options are available for the various symptoms that may be present–symptoms such as pain, ulceration, bleeding, and infection. Diagnosis and management of these malformations is best handled by a multidisciplinary team.
AVMs are different from other types of vascular malformations in that they are significantly more aggressive. Trauma or surgery of the involved area can trigger growth of the mass and worsening of symptoms. They can “steal” blood flow from areas further away causing ulcerations and decreased blood flow to fingers and toes. In the worst case, they can cause heart failure secondary to overexertion of the heart to provide blood flow to the area. Treatment can include embolization, sclerotherapy, or surgery. Compression garments can also be helpful.
Dr. Panossian has been treating patients with AVMs for over a decade. Treatment is usually reserved for patients that have become symptomatic, as described above. Surgery is still considered to be the only curative intervention, however, a combined approach is often employed. Surgery may or may not be preceded with embolization of large feeding arteries. Embolization alone may be helpful in alleviating symptoms temporarily and under rare circumstances, can stop expansion of an AVM. New approaches are being researched. Although benign, AVMs are considered one of the most difficult vascular malformations to treat.
Why choose Dr Panossian
- He received his medical education at Tufts University School of Medicine.
- Graduated at the top of his class at UCLA, receiving Phi Beta Kappa and Summa Cum Laude honors.
- Was accepted into an elite combined general surgery and plastic surgery residency at the Keck School of Medicine of USC.
- Completed subspecialty training in craniofacial surgery at the Hospital for Sick Children in Toronto and Harvard Medical School.
- Was mentored by Dr. Ron Zuker in the practice of facial paralysis reconstruction. This prestigious fellowship position was available to only one surgeon in the United States.
- Is affiliated with various charitable and educational organizations, including Operation Smile and Mending Kids.
- Is a member of the American Society of Plastic Surgeons and the highly selective American Association of Plastic Surgeons, reserved for only a select group of individuals nationally who have demonstrated excellence in academic plastic surgery.
- Holds memberships in several other professional societies including the American College of Surgeons and the American Society of Reconstructive Microsurgery.
- He serves on the Board of Directors for Mending Kids and the Gondobay Manga Foundation, a non-profit organization dedicated to the improvement of lives in Sierra Leone.
- Has been nominated by his peers annually since 2012 as a “Super Doctor.”
- Served as an expert medical consultant and appeared on The Doctors, Grey’s Anatomy, and Nip/Tuck.
- Has been featured as “Top Doctor” in US News and World Report, Pasadena Magazine, and Los Angeles Magazine.
Last modified by Dr. Andre Panossian