Muscle atrophy due to femoral vascular malformation

Doctor Thi Van Ginger, Head of the Endovascular Intervention Unit, Center for Diagnostic Imaging and Interventional Radiology, Tam Anh General Hospital, Ho Chi Minh City, said that the large venous malformation in the patient’s left leg has a zigzag structure, about 28 cm long, located deep in the muscles of the left buttocks and thigh. This damage causes partial muscle atrophy, causing the patient lasting pain.

In normal people, blood circulates from the arteries through capillaries and then back to the veins. When blood vessels are malformed, blood flows directly from arteries to veins or through abnormal vascular tufts, causing faster flow and higher pressure than normal. Vascular malformations in the thigh often involve the femoral arteries and veins. Patients may experience swelling, dull pain, heavy legs, local heat or prominent abnormal blood vessels. If detected and intervened late, this condition causes chronic pain, limb edema, bleeding, skin ulcers, and affects motor function.

Endovascular intervention team to eliminate vascular malformations for patients. This method helps directly access the malformation from within the vessel, limiting invasion, reducing the risk of bleeding, and maximally preserving the surrounding muscle structure. Thanks to the digital subtraction angiography (DSA) system, the doctor can see the abnormal blood vessel map, thereby clearly identifying the branch going into the malformed cluster, the branch draining to the superficial vein system.

Doctor Ginger chose 99.5% refined alcohol as the sclerosant and injected it directly into the malformed veins. High concentrations of alcohol have the effect of damaging the endothelium of blood vessels, causing malformed vessels to shrink, become fibrotic, and gradually be eliminated. Compared to some other sealing materials such as medical glue, alcohol has the advantage of penetrating deeply into complex deformities.

The intervention went smoothly. In the following days, the patient was closely monitored for lower limb pulses, used regular pain medication, and discharged after one day.

Dr. Ginger advised patients to have regular check-ups to monitor the effectiveness of treatment. Vascular malformations can silently exist for many years, until pain, muscle atrophy or complications are discovered. Early examination and correct diagnosis using modern imaging tools such as CT, MRI or DSA… help choose appropriate treatment methods and avoid surgery.