FEATURE
The collaborative spirit
Inside a multispecialty vascular anomalies clinic By Abhay Srinivasan, MD
many years, vascular anomalies were a poorly defined entity where diagnoses overlapped and physicians, unsure how to diagnose or specify the lesions, would refer to them in broad terms such as “hemangiomas.” Since the 1990s, there have been efforts to better define these anomalies, characterize them and target their care.
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Because of the ambiguity, broad range and scope of vascular anomalies,
20 IRQ | WINTER 2024
he range of vascular anomalies is extremely broad and variable, and these lesions can show up in any part of the body. For
multiple specialists are often involved in treatment. At my institution, we have a multidisciplinary care clinic that has evolved to encompass specialties from many pediatric departments. These departments work together to create longitudinal care plans, often with interventional radiology as an integral specialty.
Creating a team When I joined the Children’s Hospital of Philadelphia (CHOP) in 2015, the vascular anomaly service was run by David Low, MD, an accomplished plastic surgeon collaborating with
interventional radiologists, (Anne Marie Cahill, MD, FSIR, and myself) to conduct a bidisciplinary clinic service staffed by surgery and IR. However, there were numerous other specialties that could potentially be required for the treatment and management of a patient’s lesion but that were not involved in that clinic. For example, if a patient needed to see an ear, nose and throat (ENT) specialist, they would be referred separately to that physician and undergo treatment outside of the clinic—so while there were collaboration opportunities, it was not truly multidisciplinary.
In 2020, CHOP hired an oncologist, Denise Adams, MD, who specializes in the management of vascular anomalies. Concurrently, there was an initiative to set up a “frontier program”—a special undertaking that utilizes hospital funds to provide start-up services including research and clinical care for a subspecialty service line.
The goal of the vascular anomalies frontier program at CHOP was to establish a multidisciplinary clinic that employed hematologist–oncologists
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