Vascular hamartomas and hemangiomas: classification and treatment.

Former classifications of hemangiomas and other congenital vascular anomalies have been confusing, inconsistent, and often unrelated to clinical prognosis. I propose a simplified classification of all vascular hamartomas. Primary involvement of the afferent versus the efferent sides of the fetal vascular tree appears to be correlated with the postnatal growth potential of these lesions, and this forms the basis for the new classification. Four relatively new and useful treatment technics are systemic steroid therapy, thrombin-Gelfoam embolism, laser therapy, and interstitial resection and reconstruction. Proper integration of these with older established treatment methods significantly reduces deformity and functional loss in most patients with vascular hamartomas.