What do Cochrane systematic reviews say about congenital vascular anomalies and hemangiomas? A narrative review

Autores

Palavras-chave:

Vascular malformations, Hemangioma, Arteriovenous malformations, Lasers, dye, Laser therapy

Resumo

BACKGROUND: Congenital vascular anomalies and hemangiomas (CVAH) such as infantile hemangiomas, port-wine stains and brain arteriovenous malformations (AVMs) impair patients’ lives and may require treatment if complications occur. However, a great variety of treatments for those conditions exist and the best interventions remain under discussion. OBJECTIVE: To summarize Cochrane systematic review (SR) evidence on treatments for CVAH. DESIGN AND SETTING: Review of SRs conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo, Brazil. METHODS: A broad search was conducted on March 9, 2021, in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed treatments for CVAH. The key characteristics and results of all SRs included were summarized and discussed. RESULTS: A total of three SRs fulfilled the inclusion criteria and were presented as a qualitative synthesis. One SR reported a significant clinical reduction of skin redness by at least 20%, with more pain, among 103 participants with port-wine stains. One SR reported that propranolol improved the likelihood of clearance 13 to 16-fold among 312 children with hemangiomas. One SR reported that the relative risk of death or dependence was 2.53 times greater in the intervention arm than with conservative management, among 218 participants with brain AVMs. CONCLUSION: Cochrane reviews suggest that treatment of port-wine stains with pulsed-dye laser improves redness; propranolol remains the best option for infantile hemangiomas; and conservative management seems to be superior to surgical intervention for treating brain AVMs.

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Biografia do Autor

Henrique Jorge Guedes Neto, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD, PhD. Adjunct Professor, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Danielle Akemi Bergara Kuramoto, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD. Resident, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Rebeca Mangabeira Correia, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD. Resident, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Brena Costa Santos, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD. Resident, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Amanda da Cunha Borges, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD. Resident, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Mariana Raffo Pereda, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD. Resident, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Ana Laura e Silva Aidar, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD. Resident, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Francisco Amadeu Pereira Júnior, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD. Resident, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Fabio Cabral de Freitas Amaral, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD. Postgraduate Student, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Vladimir Tonello de Vasconcelos, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD, PhD. Adjunct Professor, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Wellington Gianoti Lustre, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD, MSc. Assistant Professor, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Jorge Eduardo de Amorim, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD, PhD. Adjunct Professor, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Ronald Luiz Gomes Flumignan, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD, PhD. Full Professor, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Luis Carlos Uta Nakano, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD, PhD. Full Professor, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

José Carlos Costa Baptista-Silva, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo

MD, PhD. Full Professor, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil

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Publicado

2022-03-03

Como Citar

1.
Guedes Neto HJ, Kuramoto DAB, Correia RM, Santos BC, Borges A da C, Pereda MR, Aidar AL e S, Pereira Júnior FA, Amaral FC de F, Vasconcelos VT de, Lustre WG, Amorim JE de, Flumignan RLG, Nakano LCU, Baptista-Silva JCC. What do Cochrane systematic reviews say about congenital vascular anomalies and hemangiomas? A narrative review. Sao Paulo Med J [Internet]. 3º de março de 2022 [citado 14º de março de 2025];140(2):320-7. Disponível em: https://periodicosapm.emnuvens.com.br/spmj/article/view/871

Edição

v. 140 n. 2 (2022)

Seção

Revisão Narrativa

Licença

Creative Commons License
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.