Venous malformations of the lower limb: A review of 110 cases

Venous malformations (VMs) are slow-flow vascular malformations that are present at birth and gradually worsen during the lifetime of the patient. Lower-limb VMs are either localized or diffuse and extensive, and they infiltrate the skin, muscles, joints, and occasionally the bones. A retrospective review of medical records and imaging details of 110 patients with lower-limb VMs was performed. The presentation, associated features, and radiographic findings were documented. The extent of the VM lesions was categorized into upper (24 %), lower (44 %), and whole leg involvement (33 %) types, and the depth was categorized into subcutaneous (21 %), muscle (77 %), and bone involvement (3 %) types. The majority of the patients in our series had pain. Eleven patients (10 %) had joint deformity secondary to VM involvement of the soft tissues. Twenty-one patients (19 %) had a leg length discrepancy. Radiographic imaging indicated the presence of microarterio-venous shunts in all such patients. The management of VMs in the upper and lower limbs is complex. In contrast, we have encountered a case of whole-leg VM with no complications that has been treated multiple times with sclerotherapy at our facility. An optimal management strategy can yield acceptable results with minimal morbidity.