Neodymium‐YAG Laser for hemangiomas and vascular malformations – long term results

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Abstract
Hemangiomas and vascular malformations are the most common vascular lesions of infancy. Different lasers can be used for treatment. Nd:YAG laser photocoagulation is particularly effective because of its deep penetration into tissue. Thirty-one patients, aged from three months to 18 years, with voluminous hemangiomas and venous malformations were treated with a cw-neodymium:YAG laser. The quartz fibre was used in percutaneous and intralesional technique. Long-term follow-up data were acquired by clinical control or a patient questionnaire for a maximal period of eight years. Twenty patients could be evaluated. In the group with hemangiomas (n = 15), three cases showed nearly complete remission (> 90 %), ten cases had a partial reduction in size (50 - 90 %), in one case there was stable disease and in one case tumor growth. In the group with venous malformations (n = 5) two cases showed an excellent response (> 90 %), one case a moderate response (25 - 50 %) and in two cases there was no improvement. Adverse effects included scars (40 %), hyper- and hypopigmentation (23 %), mild atrophy (20 %) and a wrinkled texture (17 %). After maximal reduction in size, 30 % of the patients were not satisfied with the laser treatment outcome and elected surgical excision of the residual lesion. The neodymium:yttrium aluminium garnet (Nd:YAG) laser with percutaneous or intralesional application technique is a valuable tool for selected patients with hemangiomas and venous malformations.