The use of the indications of the laser in treatingvascular malformations and infantile haemangiomas isbased on the theory of selective photothermolysis, inwhich the oxyhaemoglobin is the target chromophoreon which the light of the laser acts, thus avoiding damageto neighbouring tissues. The pulsed dye laser is themost employed and at present is the treatment ofchoice in capillary malformations (port-wine stains). Avariable response is obtained, with a substantial clearingof the colour of the lesion after several sessions.Application at early ages seems to improve the results.Venous malformations, especially those localised inthe mucosa, respond better to the Nd:YAG laser; lymphaticmalformations to the CO2 laser. Arteriovenousmalformations rarely respond. Use of the pulsed dyelaser in the phase of proliferation of the haemangiomasis subject to controversy, except where there is ulceration.A rapid re-epithelialization is obtained in thesecases following its use. In the involution phase,patients with residual vascular lesions can benefit fromother lasers such as KTP or Nd:YAG. If they show anatrophic surface and scars these complicationsimprove with the CO2 laser or Er:YAG. New treatmentmodalities are emerging, such as photodynamic therapy,whose efficacy and safety, both in the treatment ofhaemangiomas and vascular malformations, have yetto be confirmed.
展开▼
