The most common vascular anomaly seen is a capillary malformation called a port-wine stain. This is sometimes called an angel kiss or stork bite. It can be pink, red, purple, or a variety of discolorations that are usually on the surface of the skin and are usually not raised. They are made up of small, teeny, tiny blood vessels called capillaries, which are just behind the skin. They frequently are on the face but can be seen in other parts of the body. One kind of port-wine stain, which is important to be aware of is Sturge-Weber syndrome. This facial port-wine stain can involve the brain and can, over the long term, produce glaucoma or seizures. It needs to be evaluated very closely by a pediatric plastic surgeon as well as a neurologist.

Laser treatments are excellent for vascular anomalies such as port-wine stains and other capillary malformations that are less effective in treating hemangiomas. Lasers are typically reserved in hemangiomas for those that are bleeding or ulcerating early during the proliferative phase or following the involution phase for treating small telangiectasias or abnormal blood vessels. It is not realistic to think that a laser will make a proliferating hemangioma go away. In terms of vascular birthmarks, treatment needs to be repeated multiple times in order to maximize the removal of the lesion and prevent any burning or scarring on the skin. Many of these lesions can also be covered with topical cosmetics and working with a good cosmetologist can significant improve the appearance of many of the lesions, especially the flatter ones on the face

Another common type of vascular malformation is the lymphatic malformation. These have also been called cystic hygromas. These anomalies occur following abnormal growth of lymph vessels, which carry fluid from our lymph glands through out blood and help remove bacteria from our body tissues. Lymph vessels drain fluid from areas of the body that become swollen after infection. If they are malformed at birth, they often look like large, soft masses and are usually in the head and neck region. They are often tangled all around muscles, skin, and bones.

Infection is the most common problem associated with lymphatic malformations or lymphangioma. While most infections are minor and disappear with antibiotics, some are very severe, causing rapid growth and must be treated surgically. Because repeat infections are common, your doctor may recommend prophylactic treatment not only with antibiotics, but also by surgical and interventional radiology methods.

Dr. Stelnicki frequently works with a pediatric radiologist to optimize the treatment of these lesions. He may order an MRI (magnetic resonance imaging) study and a special blood vessel study to evaluate the lymphangioma or vascular malformation prior to any therapy. Prior to surgery he will consult the interventional radiology unit at for either percutaneous sclerotherapy and intravascular embolization. This decreases the size of the lesion and the amount of bleeding. It is our practice to involve a multidisciplinary approach to decreasing these lesions so as to decrease the amount of surgeries needed and the amount of overall scarin

Heart problems can also occur with vascular birthmarks called arterial venous malformations. These malformations can steal blood flow away from important systems in the body and cause the heart to work harder than it should and cause heart failure. If this occurs, then early intervention is required

Vascular malformation, surgery is reserved for those large lesions that are causing overgrowth of an organ system in an area significant distorting tissue and all surgery needs to be performed by a combination of both interventional radiology techniques and direct surgical excision. Dr's Stelnicki works hard to decrease the amount the of scarring that will be present following any surgical interaction.

It is important to be involved not only in the vascular anomalies team but also develop a support network. Dr. Stelnicki, through the Facing it Together Foundation has linked families of children with vascular anomalies. This allows families to realize they are not the only ones dealing with this problem. Our office will help you contact other families who are going through the same problem and have also been through it, so that you can have some point of reference as to what to expect in the upcoming years. Dr. Stelnicki and the vascular anomalies team at Joe DiMaggio Children's Hospital will follow you closely throughout your child's life until the treatment for your hemangioma or vascular malformation has been optimized. Additional information is also available through the Cleft Palate Foundation that has a link on this web site.

Sturge Weber is a syndrome wherein capillary malformations develop in the face along the distribution of 2 nerves called the maxillary and mandibular branches of the trigeminal nerve. This syndrome is associated with seizure activity, blindness, intracranial vascular lesions, and leptomeningeal calcifications. If a patient presents to our group with this type of lesion, a full neurologic and nuerosurgical evaluation is initiated.