Conditions We Treat

The first step in the treatment of this diverse group of conditions is making the proper diagnosis. Many, if not most of the patients we see in initial consultation have been misdiagnosed in the past. At the AVM Center of New York at Lenox Hill, our goal is to correctly diagnose and treat the unique medical problem that you or your loved one is facing.


This term is commonly (and mistakenly) applied to all congenital vascular lesions, but it actually describes a very distinct condition which is confined to infancy and early childhood. This is the lesion seen in infants and sometimes referred to as a “strawberry birthmark.” It is quite common in the general population, occurring in up to 12% of infants. It is significantly more common in premature infants, females, and in the Caucasian population, and may be present at birth or appear shortly thereafter. It is a single lesion in most infants, but can be multiple on occasion. This is not a malformation but a benign tumor of the endothelial cells (the cells which normally form the walls of blood vessels). What makes these conditions unique is their characteristic progression through three distinct stages: appearance (at birth or shortly after), a “proliferative” stage when the hemangioma can grow quite rapidly (lasting weeks to months) and the “involution” stage (spontaneous fading of the bright red color, shrinkage and resolution), usually by the age of 7 or 8 years.

Diagnostically, most hemangiomas have such a typical appearance and follow such a predictable chronological course that the diagnosis is easily made clinically and no further diagnostic testing is required. On occasion, a hemangioma located more deeply may appear as a soft tissue mass, which may require imaging studies (CT, MRI) or rarely a biopsy to confirm the diagnosis. While CT and MRI scans are ‘non-invasive” tests, they will generally require sedation or anesthesia in infants and children, so that their use is reserved for lesions which are of indeterminate nature clinically or when treatment is required.

read more about hemangioma

vascular malformations

Arteriovenous Malformations (AVM), Venous Malformations (VM), Lymphatic Malformations (LM)

Vascular malformations are congenital abnormalities in which some part of the vascular system develops abnormally. These tend to be present from birth and in most cases do not run in families, so that they are considered congenital but not genetically transmitted. Usually these are isolated abnormalities in an otherwise normal individual. They may be found incidentally or cause symptoms ranging from mild discomfort to very severe medical complications. There are a large number of classification systems which are too complex for a nonprofessional to deal with, however there are certain specific categories which will be easily understood.

the most common conditions include:

hemangiomas port wine stains arteriovenous Malformation (True AVM) arteriovenous fistula venous malformation KLIPPEL TRENAUNAY
Klippel – Trenaunay Syndrome
One of the most common forms of venous malformation (despite its exotic-sounding name) is Klippel-Trenaunay Syndrome (KTS), which generally involves a single extremity (usually the leg, less commonly the arm) and includes over- or undergrowth of the involved limb, varicose veins, and a port wine stain (capillary venous malformation).. There can be a wide range of signs and symptoms, ranging from mild one-sided varicose veins and a barely visible birthmark, to unusual severe forms which can cause significant deformity and disability. Like most vascular malformations, this condition is congenital but not genetically transmitted, and is rarely seen in other family members. Some patients with mild symptoms will need only conservative measures, such as support stockings and elevation of the limb. Patients having more extensive conditions with swelling, pain, and cosmetically disfiguring malformations were formerly felt to have few treatment options, but this situation has changed over the past several years. Effective treatment is now available for many patients ranging from laser treatment for port wine stains to endovenous ablation, direct embolization or sclerotherapy of abnormal veins, and in some cases plastic surgical “debulking” procedures. In some children with significant limb length discrepancy, carefully timed fusion of the growth plate (epiphysis) at the knee is performed by specialized orthopedic surgeons in order to minimize the leg length difference when full growth is attained. It also used be thought that most or all patients with KT Syndrome had absent or abnormal deep veins, which would make treatment of the symptomatic veins inadvisable or even dangerous. Many medical and surgical texts still state that these conditions are untreatable and should be left alone. We have found that the vast majority of patients with KTS do have normal deep veins, allowing the symptomatic abnormal veins to be treated safely. Prior to treatment, the status of the deep venous system is documented by ultrasound, MRI, or contrast venography. An unusual variant of Klippel Trenaunay Syndrome is one in which there is an arterial component to the malformation; this is termed Parkes Weber Syndrome, and these patients may benefit from arterial embolization to reduce the pressure in the abnormal veins. Ultrasound and MRI studies will generally allow this diagnosis to be made accurately.
lymphatic malformations