ISSVA World Congress 2024: The Latest in Vascular Anomalies

Madrid - Spain May 7-10, 2024 Disclaimer The opinions and views expressed in this supplement are solely those of the authors and do not necessarily represent the positions or recommendations of ISSVA or Wolters Kluwer. Although these abstracts are published, they have not undergone extensive scientific scrutiny or a comprehensive peer review process, aside from review and acceptance by the ISSVA World Congress Scientific Committee. To preserve the integrity of the submitted abstracts, the following published abstracts are presented as originally provided by the authors, without edits. All authors were given the opportunity to withdraw or retain their abstracts in this publication. Previously published works, if reported by the authors, were not included. Similarly, abstracts electively withdrawn by authors, are excluded from this supplement. Readers are advised to independently verify any information, methods, compounds, or experiments described herein. ISSVA and the publisher assume no responsibility for any injury or damage resulting from the application or use of the methods, products, instructions, or ideas contained within this material. Session 1: Vascular Tumors Differences in the clinical characteristics of Infantile Hemangiomas in preterm and term infants: Prematurity confers greater risk of permanent cutaneous sequelae. Flora E. Bradley (Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California); Esteban Fernandez Faith (Nationwide Children’s Hospital and Ohio State University); Sonal D. Shah (Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio); Mitchell Braun (University of California San Francisco); Elena Pope (The Hospital for Sick Children and University of Toronto, Toronto, Canada); Irene Lara-Corrales (Division of Pediatric Dermatology, The Hospital for Sick Children and University of Toronto, Toronto, Canada); Patricia M. Witman (Division of Dermatology, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio); Katya Harfmann (Division of Dermatology, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio); Amy Buros Stein (Pediatric Dermatology Research Alliance); Ilona Frieden (UC San Francisco) PURPOSE: Preterm infants have a higher incidence of infantile hemangiomas (IH) as well as a risk of multiple IH. However, specific morphologic characteristics of IH in premature infants have not been well-characterized. We observed many preterm infants with unexpectedly thick IH, a subtype known to be associated with increased risk of scarring. Because of the potential clinical significance for management, we undertook a study to compare the clinical features of localized IH in preterm versus term infants, to confirm this observation with the goal of improving the care of this patient population. METHODS: A retrospective study at tertiary referral centers was conducted on 830 consecutive patients with a clinical diagnosis of localized IH and available clinical photographs. We compared the clinical features of hemangiomas in preterm (<33 weeks and 33-<37 weeks) versus term (37 weeks) infants. RESULTS: Preterm infants had a significantly higher incidence of superficial IH (75% in <33weeks, 57% in 33-<37 weeks, and 50% in term infants, p=0.007). Prematurity and degree of prematurity were also associated with a thicker superficial component (p<0.001). A stepped border was more frequent in premature infants: (79% in <33weeks, 54% in 33-<37 weeks, and 35% in term infants, p<0.001). These features correlated with the degree of prematurity. The average chronological age at presentation to the specialist was 5.6 (SD=6.2) months, with no difference between gestational age. CONCLUSION: IH in premature infants are significantly thicker with stepped borders, specific morphologic characteristics that have previously been shown to have a greater risk of permanent skin textural changes. This has obvious implication for systemic therapies. Most of these infants were seen by pediatric dermatologists for evaluation and initiation of treatment beyond the typical proliferative phase when irreversible skin changes may have already occurred. Early specialty referral and evaluation are critical to determine if and when intervention is needed. Multifocal congenital hemangiomas: expanding our understanding of “neonatal hemangiomatosis”-case series Daniela Peeva (GOSH); Gabriela Petrof (GOSH); Lea Solman (GOSH) PURPOSE: Congenital haemangiomas are rare, benign, vascular tumors, that are present and fully grown at birth. They are typically solitary, categorized by their postnatal behavior as rapidly involuting(RICH), non-involuting(NICH), or partially involuting (PICH).They differ from infantile haemangiomas by the lack of immunostaining for GLUT-1. We present three infants with congenital, small, multifocal, non-progressive haemangiomas on the skin. METHODS: We present three cases with multiple congenital haemangiomas, which would previously be named neonatal haemangiomatosis. RESULTS: Our first patient was a male, born with 18 small vascular lesions. Abdominal ultrasound showed three vascular lesions in his liver and one in his left kidney, which were not visible on the repeated ultrasound in 3 months. MRI of the thorax showed a vascular lesion in the right hemithorax. He was completely asymptomatic, and the lung lesion was monitored annually with ultrasound. The second patient was a male, born with eight vascular lesions. He had an abdominal ultrasound, which was clear. He was also asymptomatic, and the lesions disappeared in the first year. The third patient was a female, born with 24 vascular lesions. Cranial ultrasound was clear; however, MRI head revealed nine punctate white matter lesions suggestive of vascular lesions. She had three small foci in the liver, consistent with haemangiomas, which were not detected after 6 weeks. All three patients had skin biopsy, which showed thin-walled dilated vessels in the dermis, negative for GLUT1 and D240. None of the patients had coagulopathy. CONCLUSION: These three cases expand the diagnosis of congenital haemangioma to include a multifocal phenotype and demonstrate their possible association with visceral and intracranial lesions/abnormalities. DeepIH: A Near-patient Diagnostic System for Infantile Hemangiomas Yajing Qiu (Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University); Mengjie Xu (ShanghaiTech University); Zihao Zhao (ShanghaiTech University); Lanzhuju Mei (ShanghaiTech University); Sheng Wang (ShanghaiTech University); Qian Wang (ShanghaiTech University); Dinggang Shen (ShanghaiTech University); Lin Xiaoxi (Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University) PURPOSE: Infantile hemangiomas (IH) can pose potential complications, leading to functional impairment or permanent disfigurement if not properly diagnosed and treated. However, the traditional diagnostic methods for IH heavily rely on clinical expertise and expensive medical imaging equipment, presenting challenges for resource-limited hospitals. To address this issue, we propose DeepIH, a deep learning-based near-patient diagnostic system that enables patients to receive clinical advice using images captured on their smartphones. METHODS: The DeepIH system consists of two stages. In the first stage, a convolutional neural network (CNN)-based detector is trained to localize potential lesion regions within the images. Subsequently, in the second stage, the detected region, along with its surrounding pixels to ensure a comprehensive field of view, is fed into a ResNet50 model for feature extraction. These features are then utilized by a multi-layer perceptron (MLP) to provide treatment advice based on the features of the lesion areas. To enhance the reliability of the treatment advice, we incorporate the modeling of visual and clinical uncertainty via Gaussian distance mask and distribution estimation. RESULTS: Experiments were conducted on 5081 samples collected from Shanghai Ninth People’s Hospital. The a of with treatment advice in the second stage, DeepIH an compared the of uncertainty and with CONCLUSION: DeepIH is a near-patient diagnostic system for infantile hemangiomas that images and deep The system in lesion and treatment advice based on features of the detected lesion areas. has the potential to IH diagnosis in resource-limited and for patient treatment of infantile hemangiomas of and risk with Medical PURPOSE: of infantile hemangiomas which to the and risk to the is with the of systemic - of the of and to the of these after the of the in to not have the to METHODS: We were to treatment and expand the for the treatment of IH of the and risk using In we diagnosed with - to a risk with with - were were for - not or the A of was The and of application were to the of IH. RESULTS: or was in if was the age of 3 in - if at in - if at The average of the treatment was In patient a systemic skin was in - in the of in - skin In cases not systemic CONCLUSION: are an and of treatment of IH of risk and The of treatment initiation is critical to (University of for Medical Department of of Pediatric Children’s School of PURPOSE: is a vascular of which left can have from Early diagnosis and intervention are for of of these vascular Diagnostic as as well as in the have the to the diagnosis and treatment of our has been a in the of this was has and on patient Our to the of vascular at for do in the they on In have been METHODS: A the diagnosis and treatment of was to pediatric the diagnosis and treatment of vascular RESULTS: Our in from pediatric with a in the treatment of vascular We no in for or and CONCLUSION: A of and pediatric We have that our from those of our at We propose to our also a to an for the is our that a would be to the patient and and of A study of the associated with University School of University); University); School of and Children’s Hospital of (University of University); University); Ilona Frieden (UC San Francisco); University); Hospital, University); College of University); E. University); Wang University); University) PURPOSE: Infantile hemangiomas can be associated with multiple congenital in the are associated with congenital in which the phenotype is by the of multiple of the in include These also and vascular METHODS: We in a with multiple we using the and we a that clinical in the of and based on patient phenotype to known of the of multiple in an was using on and and in the using a a in we in with We to and and associated based on RESULTS: the we and multiple for these via the we in the we first and we and We that with in the CONCLUSION: These that to the of in in of Infantile of of in a a (University of California - San Francisco); (University of California, San Francisco); Ilona Frieden (UC San Francisco); (University of California San Francisco - Children’s PURPOSE: Research has revealed that and Infantile to and treatment with when can and in We the of of on care of patients with IH. METHODS: were utilized to patients diagnosed with IH at age or at a between were on age at diagnosis and RESULTS: infants were included. The of diagnosis were and months, The was and were and were of patients age and revealed infants with were diagnosed infants patients were also to receive and treatment was in were to receive with was in infants compared to age at diagnosis was by of use were also and CONCLUSION: This study is the to of and of and to evaluation and treatment for IH. in care were in and The in patients that may also treatment study is to and care Session Vascular Tumors a as a potential in Wang Hospital of University); Hospital of University) PURPOSE: To the and the and in METHODS: was on 3 one Congenital one Infantile (IH) and skin. The three as We conducted and based on we to and RESULTS: A of in were for with a of and a of detected eight are of that the of were was compared with skin on and and were in the were compared with infantile and congenital and and with specific or in were which the of in was the from that of IH and and showed associated with CONCLUSION: The is expressed in which be a for The be a for of and in with infantile hemangiomas with Medical University in Medical University in Medical University in Medical University in PURPOSE: is a treatment for infantile hemangiomas (IH) in is and as and in is in is a risk of of the is are no for in IH with The was to of treatment in with IH of the were METHODS: of the of treatment in with IH had and were and after the of was after RESULTS: and with IH were with - had In patients a to for age and was observed at from after initiation on of in In the and a to with after In a second was observed after at a of and after to was not in any of the of was observed after CONCLUSION: The for in with IH on is and observation of of is not an to withdraw the with is in IH for of People’s PURPOSE: is a vascular with a risk of may into which by and the of associated with is To the clinical characteristics of patients with and the treatment for of METHODS: review of patients diagnosed with between and in our we lesions into three based on the and the of into three by and of of were with RESULTS: In our were lesion at in of clinical characteristics a cutaneous associated or of our patients patients were given of of without after of of patients of of cases in cases at one and three after CONCLUSION: Our study the of patients have been given an to with following of which an for the treatment of and patients from risk Early intervention may be the treatment for treatment is the for the of for a clinical Hospital of University); Hospital of University) PURPOSE: is a vascular that in or is a treatment for Most of to be an However, higher of treatment can as which the of of the we conducted this study to if is to the of METHODS: and patients with were and for to compare the of at at of in and the incidence of RESULTS: A of patients with were in the and in the with a to of was no difference in between the two of treatment with of patients in the had an compared with of patients in the was no difference in the the of were in patient in the patient in the CONCLUSION: The of in the was to that in the the were those in the treatment of vascular in M. University); University); University); University); University); University); University) PURPOSE: This the to and treatment of vascular of the head and in the METHODS: We present two cases of patients presented with and congenital hemangiomas with revealed with of and was as of a and care of these was these that more with and not to medical RESULTS: with of the multiple were via the in one and the in the were were by by the pediatric are consistent with congenital in patients with features of in patients were with rapidly after of their The also rapidly in with clinical and The were at and 6 for patients and are and their CONCLUSION: Congenital hemangiomas of the head and are are the in that rapidly and medical has its in these the of the and treatment with are in the of and of these Session to by in of University); of University); of University) PURPOSE: are vascular by and in vascular and have been to be in This to the of increased in the of METHODS: and were to and were from the and with and by were with and expressed in were detected using and using the of in was detected using in the of on the and of were by and and were to verify the of RESULTS: The and was in showed no and of showed that the of was significantly from that of and that to more compared to and was the significantly in presented and increased in areas. The of and of were after with these CONCLUSION: to the of by phenotype of by Medicine, of Medicine, of Medicine, of Medicine, of Medicine, of Plastic Surgery, Hospital for Dermatology, Hospital for Lea Solman Dermatology, Hospital for Dermatology, Hospital for Medicine, of Dermatology, Hospital for PURPOSE: is a rare, by multifocal the and in and and can to and is by in in 50% of which the However, patients are for these the The of this study was to the of in a patient for known to the and METHODS: A with and with and was for from skin was on a and associated from skin with for were by the the was in RESULTS: A was detected in skin in two samples from and to be from its This in of the of of the with of the of the in were CONCLUSION: we a as a of in a patient with a In of this is This to the of and may have for therapies. The clinical of (Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University); Yajing Qiu (Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University); (Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University); Wang (Department of Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University); Lin Xiaoxi (Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University) PURPOSE: are and may not clinical Because of its they are as They are to and diagnosis on Our vascular as as patients We have observed characteristics of The of this study is to and their clinical and to the METHODS: patients were as were in our patient were as were for this lesion and were and We then their behavior and for as well as RESULTS: This study consists of patients diagnosis was All lesions were on the or were presented as or a with with or a patients lesion or CONCLUSION: to their clinical can be categorized into This study the behavior and clinical of these of This with a understanding of the in to and University); University of PURPOSE: and of of of and has been in in the of any However, is in the pediatric age and may to in The of this study is to this and METHODS: was with an the at and after were to was with of and on MRI were treatment and compared to 6 RESULTS: patients with and with were use age was and was on a was to and correlated to and by after This not to of in patients in and and The of correlated to CONCLUSION: at a of is and to a in significantly to this is and may use in with of Vascular with an University); Hospital, School of School of Center, School of PURPOSE: of vascular with is has of treatment in frequent systemic and present the first of of with an the METHODS: cases were in patients with using a and the as a and in a for and was and for of clinical in with in of and RESULTS: to cases were using in patients with the and were had had was given as a and as an 24 and clinical was and patient was to in in or occurred. were cases of CONCLUSION: In this first with of the we demonstrate that of with can be and This the in the treatment of of of in and Children PURPOSE: To the and clinical of for vascular METHODS: of three Vascular were with to and and a was after the patients with with between and have been included. 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CONCLUSION: is an treatment for vascular with to to compared to that not be to of by with Children’s Children’s Children’s University); Children’s Children’s PURPOSE: and as and coagulopathy. treatment for patients with or that have we be to by using that following with METHODS: were by at the of and were the model of we within the and of the was using an RESULTS: of to with of was detected in in to treatment was without with without and with In with increased 3 weeks to or not they were In the increased to In in the after and in greater from to a of two that were completely which was compared to or significantly or skin was no of injury or by or CONCLUSION: This is the first of of in and of to by in with of PURPOSE: and associated of the are a The of on the To the and of in this METHODS: and patients a MRI with and The of the study were of the and of RESULTS: patients was with a age of All were with and using in and of the All had with had of were with and after The of the of of was to of the was The was to were 6 months, three patients were with one was using an after and no were observed the All patients to their CONCLUSION: The of on the of the were associated with functional A a vascular and and treatment with to A PURPOSE: and associated of the is not a The of on the and on with the risk of To the and the functional of the METHODS: patients with extensive of the had MRI and The of the study were of the and functional RESULTS: the was 3 with a age of All were with use of and had of the after treatment of of were for and of the for had of and at the 3 had and 24 after 3 had was were no months, patients were with The was patients had on patients had functional with of of CONCLUSION: The of on the of and The functional was to of of the and a vascular and and treatment with this to risk of as (University of California San (University of (University of (University of (University of California San PURPOSE: The diagnosis of a is typically by with imaging features detected on MRI and ultrasound and However, we present two clinical cases of and imaging features However, clinical and imaging to for a METHODS: 1: with left for that was a ultrasound a partially in left The patient was for by with a of an right had and MRI and ultrasound consistent with a The patient was for by and skin RESULTS: 1: the of the the a with no and not by ultrasound. the was that the be a and the was to The patient and for two weeks of the the skin The had increased in and the patient by and CONCLUSION: We present two cases of that were as The diagnosis of be in patients imaging may be or when clinical for a diagnosis is In these clinical be Session to in Children’s Children’s Children’s Children’s PURPOSE: The use of medical for is However, on and of treatment of with is not We our of patients with METHODS: We treatment and for patients with between RESULTS: patients with were by an at our presented with and All patients had or of was consistent with of was using had in A was not to be in one and from to treatment patients had clinical in and and and patients the to and CONCLUSION: to clinical in of our is a treatment for the were for the for and the of potential on the use of in to care after of for Vascular of University Research M. PURPOSE: This study the clinical of patients with a with in and as well as in of All patients and a patients were monitored for to the of clinical after This an after treatment METHODS: patients for a of one clinical was conducted for the first three months, by three RESULTS: the patients the treatment one to a lack of clinical and to The average of use was from to treatment patients were for an average of from 18 to All patients a of were the However, the two patients with a of the at 6 and one after treatment that not patients presented with with one a of an extensive a CONCLUSION: and lesions in However, the observed were not after treatment was the for into the Vascular by - and (University Hospital, (Division of Pediatric and Department of and Medicine, Medical University of of University Medical (University Hospital Medical University University Hospital, (University of Medical Medical of the University of University Hospital, (University Hospital University Hospital, University Hospital, University at (University Hospital PURPOSE: We to in the in vascular to clinical phenotype and for patient and METHODS: This retrospective study patients with vascular in of the samples were collected treatment or were detected by of of known to be associated with vascular was on from were to the with to characteristics and clinical RESULTS: vascular three vascular tumors, and one patient with a vascular and vascular presented the following distribution of in and patients with had significantly to and more frequent after treatment with significantly more compared to the CONCLUSION: This of patients with in the of the a distribution of clinical and characteristics in vascular are by more clinical with higher treatment to the as treatment to of for Vascular of University Research M.

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