Hybrid Approach to VVM

on 01/30/2018 10:09 AM

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Recently, our team began exploring the use of intraoperative sclerotherapy in conjunction with surgery.  Patients with large VVMs are offered sclerotherapy during the operation in a hybrid endovascular/surgery suite to reduce bleeding and also allow for safer removal of VVMs through smaller access incisions. This has significantly reduced our need for blood transfusions and is something particularly unique to our vascular anomalies team here in New York City and Long Island.

Laser therapy with an Nd:YAG type laser may be used  in tandem for treatment Venous Vascular Malformations involving the skin. The Nd:YAG laser targets hemoglobin (a molecule in red blood cells) and leads to the formation of a clot in the vein without deep penetration of the skin.


  • Scarring - Changes in skin pigmentation may occur, include a darkening (hyperpigmentation) and a lightening (hypopigmentation).
  • Atrophy- The tissue below the skin where the laser hit may shrink in size leading to a “sunken in” look in that area.
  • Wrinkling - The skin that was hit by the laser may wrinkle.
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