Medical Therapies for Vascular Anomalies: What Interventional Radiologists Need to Know.

Vascular anomalies comprise a heterogeneous group of vascular tumors and vascular malformations, which often require longitudinal multidisciplinary care. Interventional radiology (IR) plays a central role in the diagnosis and management of these lesions through imaging, image-guided intervention, and biopsy. Although embolization and related procedures remain fundamental, many vascular anomalies are diffuse, recurrent, syndromic, and procedural therapy alone may provide incomplete or temporary control. In this setting, medical therapy has become an important component of comprehensive care, with the potential to reduce pain, bleeding, coagulopathy, lesion activity, and the need for repeated procedures. This narrative review summarizes current medical therapies for common vascular anomalies from an IR perspective. The review addresses treatment indications, available outcome data, dosing and monitoring considerations, and treatment duration when known. As vascular anomaly care shifts toward genotype-informed and pathway-directed treatment, familiarity with systemic therapies may help interventional radiologists optimize patient selection, procedural timing, and multidisciplinary management.