Ann Dermatol.  2014 Aug;26(4):474-477. 10.5021/ad.2014.26.4.474.

The Use of Long Pulsed Neodymium-Doped Yttrium Aluminum Garnet for the Treatment of Paediatric Venous Malformations

• Sofos S
• Liew SH

• KMID: 2265588
• DOI: http://doi.org/10.5021/ad.2014.26.4.474

Abstract

BACKGROUND
Venous malformation in the pediatric population can present with pain, bleeding, or a debilitating deformity that can be difficult to manage. Sclerotherapy, surgery, and more recently, long pulsed neodymium-doped yttrium aluminum garnet (Nd : YAG) laser have been used with variable success rates.
OBJECTIVE
Our aims and objectives, were to identify the specific group of patients that would benefit from this treatment.
METHODS
A prospective clinical trial was carried out with 59 consecutive patients. The treatment criteria included a large facial deformity and painful or bleeding lesions. One to three treatments were administered at 6~8-week intervals.
RESULTS
A total of 59 patients were treated. The average follow-up was 24 months. All patients achieved good to excellent results in pain and bleeding control as well as in the reduction of the size of lesions in the lip and oral mucosa. The treatment however, is not effective in reducing the size of large, relatively high-flow lesions in the limbs. Complications from treatment include skin blistering (n=4), ulceration (n=4), and subsequent hypertrophic scarring (n=3). Three patients had partial recurrence after a 3-year follow-up.
CONCLUSION
Complex venous malformations cannot be cured but can be symptomatically controlled with the long-pulsed Nd : YAG laser treatment. The treatment satisfaction is high, and there is a small but definite risk of scarring from treatment.

Keyword

Extremities; Long pulse Nd : YAG laser; Mucous membrane; Paediatric; Venous malformations

MeSH Terms

Aluminum*
Blister
Cicatrix
Cicatrix, Hypertrophic
Congenital Abnormalities
Extremities
Follow-Up Studies
Hemorrhage
Humans
Lasers, Solid-State
Lip
Mouth Mucosa
Mucous Membrane
Prospective Studies
Recurrence
Sclerotherapy
Skin
Ulcer
Yttrium*
Aluminum
Yttrium

Figure

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  Fig. 1 (A) Mucosal lesion (palate): pretreatment with long-pulsed neodymium-doped yttrium aluminum garnet (Nd : YAG) laser. (B) The same lesion after treatment with long-pulsed Nd : YAG laser.

• 

  Fig. 2 (A) Lesion in the right thigh: pretreatment with long-pulsed neodymium-doped yttrium aluminum garnet laser. (B) The same lesion in the right thigh: posttreatment.

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  Fig. 3 Ulceration to the medial malleolus after the neodymium-doped yttrium aluminum garnet laser treatment.

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