In 2015, the CX Paediatric Vascular Issues session will host presentations on modern management of childhood vascular disorders with a special focus on vascular malformations and limb ischaemia as well as other pathologies (aortic and arterial). Course directors, Malcolm Simms (Birmingham, UK) and George Hamilton (London, UK), outline the hottest controversies in the field.

Simms says that there are at least three areas of controversy when treating children with vascular issues, “the appropriate management of iatrogenic acute limb ischaemia, the optimal management of vascular malformations and the tailoring of vascular intervention in children to address issues of growth”.

Adding to the current controversies in the field, Hamilton comments: “There is a very low level of training or at the very least understanding of available treatments and protocols in current vascular training programmes throughout Europe. As a result poor treatment and outcomes are common.” He adds, “Paediatric vascular treatment should be delivered in specialist children’s centres.” However, there is still a need to develop such centres to deliver optimal care, he notes.

With regards to improvements in the field, Simms states that the most relevant advance has been the development of smaller calibre angiography catheters and devices. “This has extended the scope of endovascular diagnosis and intervention to smaller children.” Hamilton comments that another relevant advancement is the “growing expertise and confidence in the use of thrombolysis in acute ischaemia with the huge potential to avoid amputation and save limbs.” The understanding of vascular malformations has also been improved with better nomenclature and classification, Simms adds.

The course directors note that acute limb ischaemia treatment is the area that urges most attention in paediatric vascular treatment. Even though there are some advances in the field, there is still a special need to further develop (particularly for children younger than five) small diameter endovascular catheters, wires and absorbable small diameter stents, which seem to offer the best potential for treatment because of growth issues, Simms and Hamilton comment. Simms adds that the management of large diffuse vascular malformations remains “palliative at best”.

Delegates who attend the CX Paediatric Vascular Issues session will learn about the latest treatment methods in the field and will also have the chance to discuss specific examples with case-based presentations

The CX Paediatric Vascular Issues session will take place at the Charing Cross Symposium on Thursday 30 April (morning) – London Room Learning Centre, Olympia Grand, London, UK.

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