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

Summary Background: 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. Patients and methods: 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. Results: 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. Conclusions: 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.