Lymphatic Malformations


Welcome to the APSA Quality and Safety Committee Vascular Anomalies Toolkit. This page is intended to help anyone who is interested in Quality Improvement (QI) of the management of patients with vascular anomalies.

Available toolkit projects are listed below. Many of the approaches described are evidence-based - some are not. These approaches have not been approved by APSA.

Please add a header titled "Development of a Vascular Anomalies Clinic"

The treatment of patients with vascular anomalies can be highly specialized and challenging. As such, the development and maintenance of a multidisciplinary vascular anomalies clinic (VAC) is complex. This section intends to provide guidelines and elements that may be helpful in the development of a program to care for such patients. It is a complilation of the efforts of various institutions and organizations, such as Kaiser Permanente Roseville, Children’s Hospital of Los Angeles, and the VASCERN european collaborative.



Stakeholders: Vascular Anomalies Clinic team members

Challenges and solutions:

  • Treatment of patients with vascular anomalies can be highly specialized and challenging. As such, development and maintenance of a multidisciplinary vascular anomalies clinic is complex.

Links to published data (used to develop protocol or demonstrating success of protocol):

Submitted by: Doug Miniati, MD

Additional implementers: Jason Sulkowski, MD

Recent Research





  1. Engel ER, Hammill A, Adams D, et al. Response to sirolimus in capillary lymphatic venous malformations and associated syndromes: Impact on symptomatology, quality of life, and radiographic response. Pediatr Blood Cancer. 2023;70(4):e30215.  [PMID:36651691]
  2. Ghaffarpour N, Baselga E, Boon LM, et al. The VASCERN-VASCA working group diagnostic and management pathways for lymphatic malformations. Eur J Med Genet. 2022;65(12):104637.  [PMID:36223836]
  3. Greene AK, Liu AS, Mulliken JB, et al. Vascular anomalies in 5,621 patients: guidelines for referral. J Pediatr Surg. 2011;46(9):1784-9.  [PMID:21929990]
  4. Leboulanger N, Bisdorff A, Boccara O, et al. French national diagnosis and care protocol (PNDS, protocole national de diagnostic et de soins): cystic lymphatic malformations. Orphanet J Rare Dis. 2023;18(1):10.  [PMID:36639640]
  5. Mede A, Chotai PN, Huh WJ, et al. Intra-abdominal Cystic Lymphangiomas: The Vanderbilt Experience. J Surg Res. 2023;285:197-204.  [PMID:36696706]
  6. Mehl SC, Kinley A, Todd HF, et al. Institutional Management of Abdominal Lymphatic Malformations: Evolution of Treatment Over a Decade. J Surg Res. 2022;280:296-303.  [PMID:36030605]
  7. Poget M, Fresa M, El Ezzi O, et al. Lymphatic malformations in children: retrospective review of surgical and interventional management. Pediatr Surg Int. 2022;39(1):36.  [PMID:36469112]
  8. Wiegand S, Wichmann G, Dietz A, et al. Association between malformation type, location and functional deficits in lymphatic malformations of the head and neck in children. Eur Arch Otorhinolaryngol. 2023;280(5):2535-2540.  [PMID:36695910]
  9. Zamora AK, Barry WE, Nowicki D, et al. A multidisciplinary approach to management of abdominal lymphatic malformations. J Pediatr Surg. 2021;56(8):1425-1429.  [PMID:33526253]
  10. Zobel MJ, Nowicki D, Gomez G, et al. Management of cervicofacial lymphatic malformations requires a multidisciplinary approach. J Pediatr Surg. 2021;56(5):1062-1067.  [PMID:33982660]
  11. Cardis MA, DeKlotz CMC. Intralesional Deoxycholic Acid Treatment for Fibrofatty Residua of Involuted Infantile Hemangiomas: A Novel Therapeutic Approach. JAMA Dermatol. 2018;154(6):735-737.  [PMID:29801031]
  12. ISSVA Classification of Vascular Anomalies ©2018 International Society for the Study of Vascular Anomalies Available at "" Accessed March, 2023.

Last updated: May 5, 2023