Orbital vascular lesions: Role of the interventional radiologist
Orbital vascular lesions are a complex and varied group of lesions requiring a multidisciplinary approach to management. The historical terminology and nomenclature of these lesions is confused and often misleading. A clear, pathological-anatomical basis to classification, as proposed by the International Society for the Study of Vascular Anomalies, provides a clear standardised lexicon allowing clear communication across medical specialties and evidence-based approaches to therapy. We discuss the important primary distinction between proliferative vascular tumours and non-proliferative vascular malformations. We then focus on the group vascular malformations: the low flow capillary malformation (CM), venous malformation (VM) and lymphatic malformation (LM) and the high flow arteriovenous malformation (AVM). We relate anatomical and pathological basis to the varying clinical presentations, natural history and treatment strategies of these lesions. We look at examples of cases and examine the role of multimodality imaging in diagnosis and of interventional neuroradiology in management. Finally, we look at conditions which can mimic orbital vascular lesions and the critical importance of recognising these.