• Michael J Zobel, Willieford Moses, Ashley Walther, Donuta Nowicki, Lori Howell, Joseph Miller, Chadi Zeinati, and Dean M Anselmo.
• Division of Pediatric Surgery, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, Calif.
• J Vasc Surg Venous Lymphat Disord. 2021 May 1; 9 (3): 781-784.

AbstractWe describe a 17-year-old boy with capillary malformation-arteriovenous malformation syndrome and a massive vascular malformation of the right chest wall, shoulder, and upper arm. Persistent growth of the malformation caused cutaneous ulcerations and recurrent massive bleeding episodes. We proceeded with a modified shoulder disarticulation preceded by ligation of the subclavian artery and innominate vein by median sternotomy. After a staged debulking resection of the residual chest wall arteriovenous malformation with rotational transverse rectus abdominis myocutaneous flap coverage, the patient was discharged home safely. This report demonstrates that a multidisciplinary approach is critical for management of life-threatening complications in capillary malformation-arteriovenous malformation patients.Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

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