Ep. 152 Treating Vascular Anomalies with Dr. Alex Barnacle

We talk with Dr. Alex Barnacle about her approach to the workup of Vascular Anomalies, including the importance of correct nomenclature and multidisciplinary teams for accurate diagnosis and long-term success.

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SHOW NOTES

In this episode, Dr. Alex Barnacle and our host Dr. Chris Beck discuss the diagnosis and treatments of different vascular anomalies, as well as considerations in treating a pediatric population.

We start by reviewing the terminology of vascular anomalies, noting that the terms can be complicated and misleading for providers and for patients. Dr. Barnacle explains categories delineated by the ISSVA (International Society for the Study of Vascular Anomalies). She emphasizes the importance of combining imaging and physical examination to correctly differentiate between capillary, venous, lymphatic, and arterial malformations.

Next, Dr. Barnacle highlights the interdisciplinary nature of her joint clinics, which involve a variety of specialties (dermatologists, orthopedic surgeons, plastic surgeons, and others) and physical therapists. All play a role in diagnosing, treating, and following up with patients.

When discussing sclerotherapy, we cover considerations such as sedation, sclerosing agent, two needle technique, and potential complications. Dr. Barnacle talks about managing patient and family expectations, emphasizing that large lesions may require multiple interventions. We conclude by reflecting on the current state of pediatric IR and the future growth of the field.

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RESOURCES

Commentary on Electrosclerotherapy as a Novel Treatment Option for Hypertrophic Capillary Malformations:

https://pubmed.ncbi.nlm.nih.gov/31574036/

ISSVA Classification for Vascular Anomalies:

https://www.issva.org/UserFiles/file/ISSVA-Classification-2018.pdf

ISSVA website: https://www.issva.org/