Two-stage procedures in an 11-year-old patient with Klippel-Trenaunay syndrome: A case report
Main Article Content
Keywords
Endovenous Laser Ablation (EVLA), Klippel-Trenaunay Syndrome (KTS), vein ligation
Abstract
Introduction: Klippel-Trenaunay Syndrome (KTS) is a cutaneous vascular malformation syndrome that occurs as a result of a triad of limb hypertrophy, capillary, and venous malformation. As the etiology of KTS remains incompletely understood, no definitive consensus has been reached regarding its optimal treatment or standardized management. Thus, this study aims to report the management of KTS in an 11-year-old patient.
Case description: An 11-year-old male patient presented with right lower extremity varicose veins, a bluish red cutaneous nodule of the right thigh, and hemihypertrophy that was suggestive of KTS. Doppler ultrasonography revealed multiple dilated superficial veins along the lateral aspect of the right femur extending to the right foot. The Great Saphenous Vein (GSV) and Small Saphenous Vein (SSV) were notably enlarged, with maximum diameters of 9 mm and 11 mm, respectively. No arterial abnormalities suggestive of high-flow arteriovenous malformations or fistulas were identified in the right lower limb. Varicose veins along the lateral aspect of the right lower limb were treated with Endovenous Laser Ablation (EVLA). At 3 months post-EVLA, no prominent dilated veins were observed along the lateral, medial, or posterior aspects of the limb. Due to the patient’s high-impact activities, vein ligation was planned to eliminate reflux within the lateral marginal vein. The procedure was performed at four sites along the lateral marginal vein of Servelle under ultrasound guidance. Four weeks after surgery, the patient showed marked clinical improvement, reporting no pain or discomfort. Physical examination revealed no evidence of recurrent varicose veins or other complications.
Conclusion: The combination of EVLA and vein ligation has the potential to decrease the likelihood of varicose veins and recanalization caused by blood reflux. Since there is no accepted protocol for treating KTS, the two-stage procedure may be considered as a treatment option in selected KTS cases, particularly in patients with high-impact activities.
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