John Mulliken – Mulliken & Young’s Vascular Anomalies (Second edition)

Описание

Th e First Edition of this book was conceived 25 years ago by two young surgeons. Th eir 1988 text was an
attempt to give structure and meaning to a diff use and confusing group of disorders for which science had
made few inroads and clinical care was oft en haphazard or simply ignorant. Th e fi eld of vascular anomalies
was once terra incognita , located beyond the major vessels and named tributaries and obscured by a cloud
of terminological confusion. Now this haze has largely lift ed to reveal a wondrous realm. Most of the clinical
patterns and interrelations can be seen quite clearly. Th is emerging clarity also has stimulated ever more
basic scientifi c inquiry and has encouraged inter-specialty communication and new therapeutic strategies.
Patients with vascular anomalies and their families no longer wander as “medical nomads,” searching for
someone who understands their problems. Interdisciplinary teams and referral centers have been established,
providing patients access to optimal specialized care. Th e authors of the First Edition initiated biennial
international workshops in 1976; these were later formalized as meetings of the International Society
for the Study of Vascular Anomalies (ISSVA).
Th ere were not quite six pages on pathogenesis of vascular malformations in the First Edition. Th e revolution
in molecular genetics has made possible the discovery of genes responsible for embryonic vascular
development, while the study of familial vascular anomalies has permitted the pursuit and exposure of
mutated genes. Basic research can now proceed from a structured knowledge and holds the promise of a
“molecular classifi cation” of vascular anomalies, and more importantly, novel therapies.
Th ere was only one magnetic resonance image in the First Edition. Th e technological advances in radiology
have revolutionized the fi eld and necessitated radiologic subspecialists in vascular anomalies. Diagnostic
and interventional radiologists are fi rst-line members of the vascular anomalies team. Ultrasonography and
magnetic resonance imaging (MRI) are routine. Ultrasonic prenatal diagnosis is common, and antenatal
MRI is available in specialized centers.
Th ese advances have not shown any limits to this young and fascinating fi eld; rather, they have revealed
that there is far more to learn. Th is new era has impelled the authors to muster their colleagues for a Second
Edition. Although much is new in this Second Edition, we have preserved the themes of the fi rst volume: to
provide historical perspective, to choose our words precisely, to ground nomenclature in science as well as
clinical observation, and to acknowledge what we do not know.
Our subjects remain those oft en complex vascular disorders that occupy a common ground shared by dermatologists,
radiologists, surgical specialists (plastic, pediatric, maxillofacial, ophthalmologic, orthopedic,
otorhinolaryngologic), pathologists, pediatricians, geneticists, hematologists-oncologists, and vascular biologists.
To acknowledge that this fi eld extends beyond what was implied in the original Vascular Birthmarks ,
the title has been enlarged to Vascular Anomalies so as to admit the other organ systems on an equal standing.
Although “hemangiomas” remains in the subtitle, other rare, and oft en more aggressive, vascular tumors are
included. Th e authors began writing this Second Edition over 10 years ago. We continually learned during
this decade of gestation. We believe that this textbook is worth the wait and hope our readers agree. Our
book is not the fi nal word in a realm that is evolving so rapidly. Nevertheless, we hope that it presents a
comprehensive synthesis of current knowledge in the fi eld—the well-known regions as well as the murky
backwaters that need further exploration.