麻豆果冻传媒

The understanding and management of vascular anomalies are advancing rapidly. As we identify and analyze the genetic underpinnings of these disorders and the proteins involved, we are able to address them on more fundamental and personal levels. Our deepening insights increase the power of targeted medications to slow and shrink vascular tumors and vascular malformations; and they also strengthen the application of combined therapies that may include interventional radiology (embolization, sclerosing therapy, focused ultrasound and cryotherapy), surgery and medical treatments.

Identifying genetic associations for different vascular anomalies helps us find the molecular pathways involved in the cause and progression of the disease. Some of those pathways are known to be involved in oncologic disorders and therefore have already been addressed by chemotherapy drugs. We can now repurpose some of these medications for the treatment of vascular anomalies. One of these drugs, known as sirolimus or rapamycin, has been effectively repurposed for the treatment of vascular anomalies for the last several years, as described in our and our .

鈥淎 key part of our management of vascular anomalies today is the combined use of targeted medications and surgical interventions,鈥� says Joyce Teng, MD, PhD, director of the Vascular Anomalies Clinic. 鈥淭argeted treatments can control abnormal cell proliferation and the formation of dysfunctional vascular structure, both before and after a procedure. Such a multidisciplinary approach will improve the overall outcomes of our management and reduce the disease recurrence,鈥� she says. We have successfully used this integrated approach for many patients with complex vascular anomalies and have published the results in a .

Specialists in this clinic use cutting-edge technology to improve the care of patients with vascular anomaly. Our interventional radiologists are examining the use of high-intensity focused ultrasound (HIFU) as well as cryotherapy for treatment of challenging vascular tumors. In addition, our head and neck surgeons have used many novel techniques during complicated surgeries to reduce risks during surgery and recurrence after.

鈥淥ur cutting edge keeps moving forward,鈥� says interventional and diagnostic radiologist David Hovsepian, MD. 鈥淭hat鈥檚 a great advantage of working in a multidisciplinary research center like ours; we are constantly developing new tools and methods for diagnosis and . We can now do things we weren鈥檛 capable of just a few years ago. And in five years, I suspect we鈥檒l be doing things we haven鈥檛 even thought of today.鈥�

For half a decade, the Vascular Anomalies Clinic has been compiling a powerful database of patients and treatments that helps us to determine the effectiveness of various approaches for patients with these difficult-to-manage disorders. We continually investigate the causes, clinical manifestations and natural history of these disorders as well as the outcomes of different treatments and management options. Our multidisciplinary team makes full use of this expertise to provide the best personalized care to each of our patients.

Publications

Dermatologic therapy. 2019: e12919. Lekwuttikarn R, Chang J, Teng JM.

PLOS ONE. 2019; 14 (4). Kim T, Tafoya E, Chelliah MP, Lekwuttikarn R, Li J, Sarin KY, Teng J.

Am J Med Genet A. 2019 Jun;179(6):966-977. Kumar A, Zastrow DB, Beleford D, Ruzhnikov MZ, Grove ME, Dries AM, Kohler JN, Waggott DM, Yang Y, Huang Y, Mackenzie KM, Eng CM, Fisher PG, Ashley EA, Teng JM, Stevenson DA, Shieh JT, Wheeler MT, Bernstein JA.

Current opinion in pediatrics. 2019. Z煤帽iga-Castillo M, Teng CL, Teng JM.

JAMA dermatology. 2018 Nov 1;154(11):1316-1319. Chelliah MP, Do HM, Zinn Z, Patel V, Jeng M, Khosla RK, Truong M, Marqueling A, Teng JM.

P. WILEY. 2018: 1531鈥�32. Stevenson DA, Wooderchak-Donahue W, Johnson P, McDonald J, Teng JM, Lungren M, Bayrak-Toydemir.

Journal of the American Academy of Dermatology. 2014; 70 (6): 1050-1057. Danial C, Tichy AL, Tariq U, Swetman GL, Khuu P, Leung TH, Benjamin L, Teng J, Vasanawala SS, Lane AT.

Pediatrics. 2019 Sep 11. Lekwuttikarn R, Josephs S, Teng JM.

JAMA Dermatol. 2019 Feb 1;155(2):256-257. Lekwuttikarn R, Lim YH, Admani S, Choate KA, Teng JMC.

Pediatr Dermatol. 2017 Sep;34(5):559-565. Tu JH, Tafoya E, Jeng M, Teng JM.

J Neurointerv Surg. 2017 Oct;9(10):1023-1026. Tu JH, Do HM, Patel V, Yeom KW, Teng JMC.

Am J Med Genet A. 2016 Jun;170(6):1450-4. Macmurdo CF, Wooderchak-Donahue W, Bayrak-Toydemir P, Le J, Wallenstein MB, Milla C, Teng JM, Bernstein JA, Stevenson DA.

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