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. 2020 Apr;38(4):287-342.
doi: 10.1007/s11604-019-00885-5.

Japanese Clinical Practice Guidelines for Vascular Anomalies 2017

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Free PMC article

Japanese Clinical Practice Guidelines for Vascular Anomalies 2017

Hidefumi Mimura et al. Jpn J Radiol. .
Free PMC article

Abstract

The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety, and systematizing treatment, employing evidence-based medicine (EBM) techniques and aimed at improvement of the outcomes. Clinical questions (CQs) were decided based on the important clinical issues. For document retrieval, key words for literature searches were set for each CQ and literature published from 1980 to the end of September 2014 was searched in Pubmed, Cochrane Library, and Japana Centra Revuo Medicina (JCRM). The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System (MINDS) technique. A total of 33 CQs were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy, and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence-based guidelines for the management of vascular anomalies.

Keywords: Clinical practice; Guidelines; Hemangioma; Vascular anomalies; Vascular malformation.

Conflict of interest statement

Conflict of interest of the guidelines preparation organization was managed by the Guidelines Executive Committee. The following corporations were disclosed by self-declaration of the Guidelines Committee members in the 3 year-period before 1 April 2017. Japan Pharmaceuticals and Medical Devices Agency (PMDA), Mitsubishi Foundation, Rohto Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, and Shionogi & Co., Ltd.

Figures

Fig. 1
Fig. 1
Reports of laser therapy for hemangiomas/vascular malformations (primarily venous) in various periods and types of laser used in the reports. CO2; 10 of 11 reports recommend the use for surgical resection. Argon; There are 4 reports of mixed treatments for CM and VM. Nd:YAG; There are 12 reports of its use in combination therapy with surgery, sclerotherapy, or other lasers. Alexandrite; There is only 1 report summarizing cases treated with alexandrite in combination therapy with other lasers

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