Diagnosis and Management of Infantile Hemangioma

Table 26. Key resolution outcomes in studies comparing PDL modalities (continued)
Author,
Year
Groups (n)
Quality
Age,
Months
Type
Location
Methods and
Measures of
Resolution/Response
Resolution Outcomes
Chang et al.
2001 216
G1: Non
cooled flash
lamppumped
pulsed dye
laser (82)
G2: Cryogen
spray cooling
plus flash
lamppumped
pulse dyed
laser (82)
Age, mean,
years
G1: 2.5
G2: 3.4
Type, %
Cutaneous
G1+G2:
100
G1+G2:
multiple
• Photographs
assessed by blinded
plastic surgeons
• Volume reduction,
texture, color
• Excellent: 76-100%
improvement
Good: 51-75%
Fair: 26-50%
Poor:0-25%
Volume reduction, mean score
G1: 3.84
G2: 3.96
G1 vs.G2 p=0.008
Texture
G1: 3.57
G2: 3.90
G1 vs.G2 p=0.001
Color
G1: 3.98
G2: 4.00
G1 vs.G2 p=0.155
Quality:
Poor
G = group; n = number; nm = nanometer; PDL = pulsed dye laser; SD = standard deviation
Nd:YAG Laser Compared With Other Lasers or Observation
Three poor quality cohort studies compared Nd:YAG laser to either argon laser, 217 traditional
PDL, 215 or CO2 laser or observation. 214 One study included 55 children with sequelae from
hemangioma and reported similar rates of excellent clearance (defined as 90-100% clearance)
between Nd:YAG and Argon groups and a higher rate of children attaining 50 percent or greater
clearance in the Nd:YAG group (72% vs. 52%). 217 Lesions were also scored for size length and
width, which showed little difference between groups. Heights of lesions were sub-analyzed,
which showed a greater ability of Nd:YAG to treat thicker lesions, with no excellent results in
the argon group for lesions 0.5 cm in height and greater.
In a study comparing Nd:YAG and PDL and including 50 children, 41 percent of children
receiving PDL and 30 percent receiving Nd:YAG had complete clearance of IH (p=NR). 215
Similar numbers in each group had 70 to 99 percent or