Diagnosis and Management of Infantile Hemangioma

Nd:YAG Laser With Cooling Compared With No Cooling
In one fair quality cohort study, 235 patients (mean age= 9 months) received the same
Nd:YAG laser treatment but different methods of epidermal cooling (ice chips during procedure,
n=115; ice before, during, and after treatment, n=120). 218 Children were treated until they
received an excellent (90-100% resolution) or good (50-89% resolution) result. Patients with
more extensive cooling required a mean 1.45 sessions of laser treatment compared to 2.11 in the
less extensive cooling group (Table 28).
Table 28. Key resolution outcomes in comparative studies of Nd:YAG laser with cooling
Author, Age,
Year Months
Methods and Measures
Location
Resolution Outcomes
Groups (n)
of Resolution/Response
Quality Type
Vlachakis et
al. 2004 218
G1: Nd:YAG
laser, cooled
with ice
before,
during and
after
irradiation
(120)
G2: Nd:YAG
laser, cooled
with ice only
during
irradiation
(115)
Age mean
(range)
G1+G2: 9
(3 months
to 4 years)
Type, %
Cutaneous
G1+G2:
100
G1+G2:
multiple
• Change in size
Excellent: 90-100%
area reduction
Good: 50-89%
Moderate: 20-49%
Poor: 0-19%
• Blinded assessment:
NR
Total resolution after session 1
G1: 65
G2: 39
Total resolution after session 2
Excellent
G1: 55/55
G2: 24/76
Good
G1: 0
G2: 52/76
Quality: Fair
Abbreviations: G = group; n = number; Nd:YAG = neodymium yttrium aluminium garnet; NR = not reported
Effectiveness of Surgical Treatments
Photothermolysis With Intense Pulsed Light Compared With Cryosurgery
Compared With Photothermolysis With Intense Pulsed Light Plus Sclerosis
One retrospective cohort study compared three treatment modalities in 250 infants