The Vascular Anomalies Center at Boston Children’s Hospital was recently named a Comprehensive Center of Excellence in the Treatment of Lymphatic Diseases. This designation by the Lymphatic Education & Research Network means that our center sets the highest standard for best practice multidisciplinary care in the management and care of lymphatic diseases.
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The clinicians in the Vascular Anomalies Center (VAC) at Boston Children’s Hospital diagnose, treat, and provide ongoing care for children with vascular anomalies. These vessel abnormalities can affect the capillaries, veins, arteries, lymphatic vessels, or a combination of them.
What are vascular anomalies?
We classify vascular anomalies into two groups:
- Vascular tumors are rare benign (non-cancerous) tumors formed of blood vessels that grow abnormally. They range from more common tumors such as infantile hemangiomas, to rare ones such as kaposiform hemangioendothelioma.
- Vascular malformations are benign (non-cancerous) lesions that are present at birth. They include venous malformation as well as combination syndromes such as Klippel-Trenaunay syndrome, which involves malformations of the capillaries, veins, and lymphatic vessels.
Lesions in these two groups are biologically very different and, therefore, require different treatment by an experienced team of clinicians.
Our approach to vascular anomalies
Boston Children’s VAC is considered the premier center in the world for vascular anomalies in children. Many of our physicians are internationally renowned for their expertise and innovations in this highly specialized field. Our clinical team has extensive experience in the diagnosis and treatment of vascular anomalies. Every year, we provide care to more than 2,000 patients with a variety of these disorders, from simple tumors and malformations to the most rare and complex syndromes.
The VAC takes an interdisciplinary approach to patient care. That means that clinicians from many different specialties — all with expertise in treating vascular anomalies and related symptoms — will work together to diagnose your child and develop a coordinated care plan. We offer a wide range of services for patients of all ages with vascular anomalies and their families, including:
- Comprehensive consultation services for physicians, patients, and families worldwide, including referrals to local physicians and facilities when appropriate
- The latest diagnostic and treatment approaches, many of which were pioneered by our staff
- Clinical evaluation in the interdisciplinary VAC clinic or VAC nurse practitioner clinic
- Review in the weekly interdisciplinary VAC conference
- Access to investigational drug therapies
- Basic and clinical research aimed at improving the care of patients with these disorders as well as developing new, more effective therapies
- Extensive information about educational organizations, support, and networking groups, and other patient and family resources
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The history of the Vascular Anomalies Center
Dr. John B. Mulliken began his work at Boston Children’s in 1974. Dr. Joseph Murray, then Chief of Plastic Surgery, encouraged him to study hemangiomas — non-cancerous tumors made up of extra blood vessels, commonly seen in infants. At the time, nearly all red, pink, or blue skin lesions were broadly labeled as “hemangiomas,” even though they actually represented a wide range of conditions that doctors didn’t yet have the language to properly classify.
To better understand these misclassified conditions, Dr. Mulliken joined Dr. Judah Folkman’s Vascular Biology Laboratory and collaborated with Dr. Julie Glowacki. Using special staining techniques, they studied how vascular lesions formed and behaved at the cellular level. At the same time, Dr. Mulliken was seeing many children in the Plastic Surgery Clinic with unusual skin markings, swellings, or lumps — cases that didn’t fit neatly into known medical categories. These would later be recognized as vascular anomalies, including specific types like venous and lymphatic malformations, though such terms were not widely used or understood at the time.
Working with Dr. Tony Young, a surgical fellow at another hospital, Dr. Mulliken helped organize the first international workshops focused on vascular anomalies, held in Boston in 1976 and 1978. These meetings, encouraged by Dr. Murray, later took place in cities around the world, including London, Paris, Milan, Hamburg, and Rome.
In 1980, Drs. Mulliken and Folkman launched the Vascular Anomalies Program to better diagnose and treat children with vascular conditions. Dr. Ken Fellows from Radiology was the first to join. Dr. Patricia Burrows followed in 1993, and Dr. Steven Fishman joined in 1994. Drs. Folkman and Harry Kozakevich also contributed through weekly patient review meetings.
In 1982, Drs. Mulliken and Young published a groundbreaking paper that clearly separated vascular tumors from vascular malformations — a major step forward in diagnosis and treatment. Their findings were expanded into the textbook "Vascular Birthmarks" in 1988, helping to establish vascular anomalies as a distinct field in medicine.
In recognition of its impact and growth, the program was officially designated the Vascular Anomalies Center in 1999.
Today, the VAC brings together more than 17 medical and surgical specialties to treat children and adults with vascular anomalies. Patients come from around the world to receive expert care. The team meets weekly to review cases and develop personalized treatment plans through a multidisciplinary clinic model.