Ep. 579 How to Manage Vascular Malformations: Hemangioma to AVM with Dr. Clifford Weiss

BackTable Vascular & Interventional

This week’s episode is a masterclass on vascular anomaly treatment. Brush up on your malformations with Dr. Cliff Weiss, the Director of the Vascular Anomaly Center at Johns Hopkins. He shares next-level techniques, precision diagnostics, and his 'gold standard' approach to alcohol sclerotherapy.
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This podcast is supported by:
RADPAD® Radiation Protection
https://www.radpad.com/
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SYNPOSIS
The episode begins with the most vital component of patient care: establishing a correct diagnosis through proper classification. Dr. Weiss shares his philosophy that “MRI is a conversation” - not just an image, detailing the specific MRI protocols to confidently make a diagnosis over 90% of the time. He then shares an overview of the classification system, differentiating vascular tumors like hemangiomas from high-flow and low-flow vascular malformations.
Dr. Weiss explores a wide array of treatment strategies tailored to each diagnosis. He walks through his techniques for treating low-flow malformations with sclerotherapy—using agents like alcohol, doxycycline, and bleomycin based on a lesion’s location and characteristics—and his use of cryoablation for vascular tumors. He then dives into the creative and high-stakes approaches for treating AVMs, comparing transvenous and transarterial embolization with agents like Onyx and coils, before concluding with his predictions on the future of IR in the field.
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TIMESTAMPS
00:00 - Introduction
02:36 - Vascular Anomaly Center at Johns Hopkins
06:33 - Vascular Anomaly & Malformation Diagnosis with Imaging
09:04 - Classifying Vascular Anomalies
15:55 - Vascular Tumors
18:46 - Low-Flow Malformations
27:58 - Needle Placement
29:56 - Retro-orbital & ENT Malformations
32:44 - AVM Treatment Strategy
40:41 - Following up with Patients