Duplexsonographisch kontrollierte Nd:YAG-Lasertherapie von Gefäßmißbildungen

Abstract

Vascular malformations can be studied in detail by colour Doppler sonography. These lesions are best treated by Nd:YAG laser therapy. The aim of the study was to improve the quality of therapy by the use of colour Doppler sonography guided Nd-YAG laser application. 17 vascular malformations/haemangiomas in 16 patients were treated by colour Doppler sonography guided Nd:YAG laser therapy. 5 children were less than one year of age, 4 children were between one and five years of age, the other patients were adults (age 22-57 years). The size of the vascular malformations (largest diameter) were 1.5-3 cm (8 cases), all others were larger than 3 cm. When using laser therapy in combination with colour Doppler sonography it is possible to adjust the treatment variables (dose, duration and energy of the laser pulse as well as the precise intralesional positioning) individually. As a result more than 80% of cases can be treated successfully during a single session. Larger lesions may be divided into functional units which can be treated subsequently. Through colour Doppler sonography it is possible to monitor the effects of laser treatment in vascular malformations. The development of smaller ultrasound probes has facilitated the application of laser therapy guided by Doppler sonography in the region of the head and neck. Colour Doppler sonography guided laser therapy increases efficiency and selectivity of the laser treatment. Early interventions prevent growth of the lesions and reduce long-term disfigurement particularly in children.