Venous malformations treated with dual wavelength 595 and 1064 nm laser system


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Dr. J. Alcántara González.


Background & objective  Venous malformations (VM) represent a localized error in the embryological development of the venous branch of the circulation. The management of VM is complex and challenging. The aim of this study was to assess the efficacy and safety of combined sequential pulsed dye laser (PDL)-Nd:YAG laser in patients with cutaneous or mucosal VM.

Methods  Thirty patients (age from 8 to 65 years) with cutaneous or mucosal VM treated with dual wavelength PDL-Nd:YAG laser were retrospectively analyzed. Laser parameters were 10 mm spot size with 10 ms pulse and 8–10 J/cm2 of PDL, followed with a second delay by Nd:YAG with 15 or 20 ms at 35–70 J/cm2; or 7 mm spot size with 10 ms pulse and 5–10.5 J/cm2 of PDL, followed with a second delay by Nd:YAG with 15 or 20 ms at 50–100 J/cm2. Laser sessions were repeated approximately every 2–6 months. Air cooling was applied during treatment.

Three dermatologists evaluated treatment effectiveness by means of photographs of the patients before and after laser treatment (scale from 0 to 4). Differences in the degree of clinical improvement between patients with cutaneous or mucosal VM were also assessed. Adverse events were registered. Patient satisfaction was also assessed in 19 cases (scale from 0 to 10).

Results  Mean global improvement was rated as 3.37. Mean improvement in patients with cutaneous VM was 3.35 and 3.38 in patients with mucosal VM. No significant difference between both groups was observed (P = 0.53). Long-lasting side effects included partial epilation of the eyelashes in one patient, ulceration in two patients and permanent scarring in three patients. Mean patient satisfaction was 8.55.

Conclusions  Our study concludes that dual wavelength PDL-Nd:YAG laser was effective for treatment of the superficial component of cutaneous and mucosal VM.