CC BY-NC 4.0 · Arch Plast Surg 2015; 42(05): 552-558
DOI: 10.5999/aps.2015.42.5.552
Original Article

Clinical Experience of the Klippel-Trenaunay Syndrome

Hyung Min Sung
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Ho Yun Chung
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
Kyungpook National University Hospital Vascular Anomalies Center, Daegu, Korea
,
Seok Jong Lee
Kyungpook National University Hospital Vascular Anomalies Center, Daegu, Korea
Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
,
Jong Min Lee
Kyungpook National University Hospital Vascular Anomalies Center, Daegu, Korea
Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea
,
Seung Huh
Kyungpook National University Hospital Vascular Anomalies Center, Daegu, Korea
Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Jeong Woo Lee
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Kang Young Choi
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Jung Dug Yang
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Byung Chae Cho
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
› Author Affiliations
This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2014R1A1A4A 01009584).

Background The Klippel-Trenaunay syndrome (KTS) is characterized by three clinical features, namely cutaneous capillary malformations, venous malformations, and soft tissue and/or bony hypertrophy of the extremities. The varied manifestations are attributed to the unpredictable clinical nature and prognosis of the syndrome. To elucidate the clinical characteristics of this disease, we reviewed a relatively large number of KTS patients who presented to our vascular anomalies center.

Methods We conducted a retrospective study with 19 patients who were diagnosed with KTS and treated in our vascular anomalies clinic between 2003 and 2014, and examined their demographic characteristics, their clinical features, and the treatments administered.

Results The sex distribution was balanced, with 9 (47%) males and 10 (53%) females. The mean follow-up period was 4.1 years (range, 7 months-9 years). Most of the patients received conservative treatments such as medication or physiotherapy. Compression therapies such as wearing of elastic garments/bandages were also administered, and surgical interventions were considered only when the patients became excessively symptomatic. Other treatments included laser therapy and sclerotherapy, and all the treatments were adjusted according to each case, tailored to the conditions of the individual patients.

Conclusions KTS is an extremely rare, multifactorial disorder that induces widely varied symptoms. Because of this unique feature, plastic surgeons, when not careful, tend to attach a one-sided importance to typical symptoms such as limb hypertrophy or capillary malformation and thus overlook other symptoms and clinical features. KTS can be suspected in all infants who show capillary malformations or limb hypertrophy and require a multi-disciplinary approach for comprehensive management.

This article was presented at the 72nd Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 9, 2014, in Seoul, Korea.




Publication History

Received: 06 February 2015

Accepted: 26 May 2015

Article published online:
05 May 2022

© 2015. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Klippel M, Trenaunay P. Du naevus variquex osteohypertrophique. Arch Gen Med 1900; 3: 641-672
  • 2 Jacob AG, Driscoll DJ, Shaughnessy WJ. et al. Klippel-Trenaunay syndrome: spectrum and management. Mayo Clin Proc 1998; 73: 28-36
  • 3 Lindenauer SM. The Klippel-Trenaunay syndrome: varicosity, hypertrophy and hemangioma with no arteriovenous fistula. Ann Surg 1965; 162: 303-314
  • 4 Baskerville PA, Ackroyd JS, Browse NL. The etiology of the Klippel-Trenaunay syndrome. Ann Surg 1985; 202: 624-627
  • 5 Husmann DA, Rathburn SR, Driscoll DJ. Klippel-Trenaunay syndrome: incidence and treatment of genitourinary sequelae. J Urol 2007; 177: 1244-1249
  • 6 Garzon MC, Huang JT, Enjolras O. et al. Vascular malformations. Part II: associated syndromes. J Am Acad Dermatol 2007; 56: 541-564
  • 7 Ziyeh S, Spreer J, Rossler J. et al. Parkes Weber or Klippel-Trenaunay syndrome? Non-invasive diagnosis with MR projection angiography. Eur Radiol 2004; 14: 2025-2029
  • 8 Servelle M. Klippel and Trenaunay's syndrome: 768 operated cases. Ann Surg 1985; 201: 365-373
  • 9 Berry SA, Peterson C, Mize W. et al. Klippel-Trenaunay syndrome. Am J Med Genet 1998; 79: 319-326
  • 10 Aelvoet GE, Jorens PG, Roelen LM. Genetic aspects of the Klippel-Trenaunay syndrome. Br J Dermatol 1992; 126: 603-607
  • 11 Craven N, Wright AL. Familial Klippel-Trenaunay syndrome: a case report. Clin Exp Dermatol 1995; 20: 76-79
  • 12 Torregrosa A, Marti-Bonmati L, Higueras V. et al. Klippel-Trenaunay syndrome: frequency of cerebral and cerebellar hemihypertrophy on MRI. Neuroradiology 2000; 42: 420-423
  • 13 Telander RL, Kaufman BH, Gloviczki P. et al. Prognosis and management of lesions of the trunk in children with Klippel-Trenaunay syndrome. J Pediatr Surg 1984; 19: 417-422
  • 14 Samuel M, Spitz L. Klippel-Trenaunay syndrome: clinical features, complications and management in children. Br J Surg 1995; 82: 757-761
  • 15 Bird LM, Jones MC, Kuppermann N. et al. Gram-negative bacteremia in four patients with Klippel-Trenaunay-Weber syndrome. Pediatrics 1996; 97: 739-741
  • 16 van der Ploeg HM, van der Ploeg MN, van der Ploeg-Stapert JD. Psychological aspects of the Klippel-Trenaunay syndrome. J Psychosom Res 1995; 39: 183-191
  • 17 Wang Q, Timur AA, Szafranski P. et al. Identification and molecular characterization of de novo translocation t(8;14)(q22.3;q13) associated with a vascular and tissue overgrowth syndrome. Cytogenet Cell Genet 2001; 95: 183-188
  • 18 Baskerville PA, Ackroyd JS, Lea Thomas M. et al. The Klippel-Trenaunay syndrome: clinical, radiological and haemodynamic features and management. Br J Surg 1985; 72: 232-236
  • 19 Alster T. Laser treatment of vascular lesions. In: Alster TS. Manual of cutaneous laser techniques. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 1999: 33-52
  • 20 Noel AA, Gloviczki P, Cherry Jr KJ. et al. Surgical treatment of venous malformations in Klippel-Trenaunay syndrome. J Vasc Surg 2000; 32: 840-847
  • 21 Gloviczki P, Hollier LH, Telander RL. et al. Surgical implications of Klippel-Trenaunay syndrome. Ann Surg 1983; 197: 353-362
  • 22 Gates PE, Drvaric DM, Kruger L. Wound healing in orthopaedic procedures for Klippel-Trenaunay syndrome. J Pediatr Orthop 1996; 16: 723-726
  • 23 Gloviczki P, Bergan JJ, Rhodes JM. et al. Mid-term results of endoscopic perforator vein interruption for chronic venous insufficiency: lessons learned from the North American subfascial endoscopic perforator surgery registry. The North American Study Group. J Vasc Surg 1999; 29: 489-502
  • 24 Kanterman RY, Witt PD, Hsieh PS. et al. Klippel-Trenaunay syndrome: imaging findings and percutaneous intervention. AJR Am J Roentgenol 1996; 167: 989-995