Résumé
The recent contribution of molecular biology and targeted therapies has considerably evolved our therapeutic management of complex lower limb malformations. We studied our Montpellier cohort (n= 63) to identify clinical features, painful episodes, and set up appropriate management.Method: this was a monocentric observational epidemiological study, retrospective in part, with prospective follow-up in the vascular medicine department, from the end of 2004 until May 31, 2023. The main objective was to evaluate pain during the management of patients with complex lower limb malformations. Results: among patients with a PIK3CA-positive biopsy (n= 21), initial pain was greater than in the biopsy-negative group: OR= 11.5 (p=0.003). Venous compression appeared essential in pain management: OR= 4.00 (p= 0.026*) in univariate analysis, ORa= 14.57 (p= 0.01) in multivariate analysis. Under specific treatment, we find an OR= 3.27 for pain reduction (p= 0.11, n= 11). Conclusion: PIK3CA+ patients had greater initial pain, but also better pain evolution under treatment. Venous compression is a major focus of pain management. Specific treatments appear promising for certain patients.