Laser Therapy of Haemangiomas and Vascular Malformations – Techniques and Strategies

• Published in: Medical laser application 2004, Vol.19 (1), p.32-44
• Main Authors: Poetke, Margitta, Philipp, Carsten M., Urban, Peter, Berlien, Hans-Peter
• Format: Article
• Language: English
• Subjects: color-coded duplex sonography; early treatment; endoscopic treatment; flashlamp-pumped pulsed-dye laser; Haemangioma; Nd:YAG laser; subglottic haemangioma; tracheal stenosis
• ISSN: 1615-1615; 1878-3228
• DOI: 10.1078/1615-1615-00122

Lasers have been used in the treatment of haemangiomas since the early 1980s. Several study groups have reported good results, others have been less enthusiastic and emphasized other treatments like cryosurgery. We reviewed our experience with the use of laser therapy in treating complicated haemangiomas of infants. During a 15-year period, 1117 infants with haemangiomas were treated with the Nd:YAG laser. The lesions reported were particular troublesome because of significant cosmetic disfigurement, maceration or ulceration, bleeding, and of potential functional impairment. Superficial findings were treated using was a transcutaneous application with local ice cube cooling to protect the overlying skin. All deep-seated lesions were treated with interstitial laser irradiation. In trachaeal haemangiomas endoscopic laser destruction is an alternative to tracheostomy with good functional results and comparable or less morbidity. Overall, excellent results were achieved in 41% of infants and good results occured in 51%. On the basis of our results we conclude that laser therapy may successfully prevent enlargement and promote involution of haemangiomas with minimal adverse effects. Therapy should be initiated as early as possible, when lesions are relatively flat, for optimal results.