Interstitial Nd:YAG laser therapy. Color-Doppler imaging (CDI)-guided laser therapy of hemangiomas and vascular malformations

Abstract

Ultrasound-(US-) guided Nd:YAG laser therapy has been reported to be promising among different other options for treatment of hemangiomas and vascular malformations. The concept of CDI-guided interstitial laser therapy is therefore a further development based on the above mentioned therapeutic regime. We examined 55 patients suffering from vascular lesions of different localization and extent pre-, intra-, and post-operatively using color-Doppler imaging (CDI). All vascular lesions were classified due to their vascularization pattern. As accurate diagnosis was imperative we decided on possible laser treatment depending on the CDI-classification. Intra-operative use of CDI rendered possible fiber-guidance by sonographic navigation and therefore precise treatment of aberrant vessels and well-perfused tumor areas. In 34 cases (62%) we observed complete, in 21 cases (38%) partial regression of vascular lesions. CDI allowed post-operative proof of diminution of tumor vascularization in all cases. CDI-guided interstitial Nd:YAG laser therapy is a minimally-invasive technique which allows replacement of conventional surgical procedures while achieving good cosmetic and functional results.CDI broadens the therapeutic possibilities in contrast to the former therapeutic concept of US-guided laser therapy due to pre-, intra and post-operative utilization of this imaging technique while significantly diminishing the intra-operative risk for the patient.