Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Lasers in Medical Science
Published in: Lasers in Medical Science 7/2020

01-09-2020 | Thermal Damage | Original Article

Thermal coagulum formation and hemostasis during repeated multipulse Nd:YAG laser treatment of cutaneous vascular lesions: animal experiment study

Authors: Dong Li, WenJuan Wu, Bin Chen, Zheming Gou, Penghui Zhao, GuoXiang Wang

Published in: Lasers in Medical Science | Issue 7/2020

Login to get access

Abstract

Laser therapy has been widely used to treat port-wine stain (PWS) and other cutaneous vascular lesions via selective photothermolysis. High incident laser fluence is always prohibited in clinic to prevent the thermal damage in normal skin tissue, leading to insufficient energy deposition on the target blood vessel and incomplete clearance of PWS lesion. In this study, repeated multipulse laser (RMPL) irradiation was proposed to induce acute thermal damage to target blood vessels with low incident fluence (40 J/cm2 for 1064-nm Nd:YAG laser). The feasibility of the method was investigated using animal models. Repeated multipulse irradiation cycles with 10-min intervals were performed in RMPL. A hamster dorsal skin chamber model with a visualization system was constructed to investigate the instant generation of thermal coagulum and relevant hemostasis by thrombus formation during and after irradiation under 1064 nm Nd:YAG single multipulse laser (SMPL) and RMPL irradiation. The diameter of the target blood vessel and the size of thermal coagula were measured before and after laser irradiation. The reflectance spectra of the dorsal skin were measured by a reflectance spectrometer during RMPL. Stasis thermal coagula that clogged the vessel lumen were generated during SMPL irradiation with low incident fluence. However, there was no acute thermal damage of blood vessels. Reflectance spectra measurement showed that the generation of thermal coagula and subsequent thrombus formation increases blood absorption by more than 10% within the first 10 min after laser irradiation. Acute vessel thermal damage could be induced in the target blood vessel by RMPL with low incident fluence of 40 J/cm2. Compared with our previous SMPL study, nearly 30% reduction in incident laser fluence was achieved by RMPL. Low fluence RMPL may be a promising approach to improve the therapeutic outcome for patients with cutaneous vascular lesions by improving energy deposition on the target blood vessel.

Literature
  1. Alper JC, Holmes LB (1983) The incidence and significance of birthmarks in a cohort of 4,641 newborns. Pediatr Dermatol 1(1):58–68View Article
  2. Kelly KM, Choi B, McFarlane S et al (2005) Description and analysis of treatments for port-wine stain birthmarks. Arch Facial Plast Surg 7(5):287–294View Article
  3. Shafirstein G, Buckmiller LM, Waner M, Bäumler W (2007) Mathematical modeling of selective photothermolysis to aid the treatment of vascular malformations and hemangioma with pulsed dye laser. Lasers Med Sci 22:111–118View Article
  4. Li D, Wang GX, He YL, Kelly KM, Wu WJ, Wang YX, Ying ZX (2013) A two-temperature model for selective photothermolysis laser treatment of port wine stains. Appl Therm Eng 59(1–2):41–51View Article
  5. Brightman LA, Geronemus RG, Reddy KK (2015) Laser treatment of port-wine stains. Clin Cosmet Investig Dermatol 8:27–33PubMedPubMed Central
  6. McClean K, Hanke CW (1997) The medical necessity for treatment of port-wine stains. Dermatol Surg 23(8):663–667View Article
  7. Bencini PL, Cazzaniga S, Galimberti MG et al (2014) Variables affecting clinical response to treatment of facial port-wine stains by flash lamp-pumped pulsed dye laser: the importance of looking beyond the skin. Lasers Med Sci 29(4):1365–1370View Article
  8. Izikson L, Nelson JS, Anderson RR (2009) Treatment of hypertrophic and resistant port wine stains with a 755 nm laser: a case series of 20 patients. Lasers Surg Med 41(6):427–432View Article
  9. Tierney EP, Hanke CW (2011) Alexandrite laser for the treatment of port wine stains refractory to pulsed dye laser. Dermatol Surg 37(9):1268–1278View Article
  10. Yang MU, Yaroslavsky AN, Farinelli WA, Flotte TJ, Rius-Diaz F, Tsao SS, Anderson RR (2005) Long-pulsed neodymium:yttrium-aluminum-garnet laser treatment for port-wine stains. J Am Acad Dermatol 52:480–490View Article
  11. Jia WC, Choi B, Franco W, Lotfi J, Majaron B, Aguilar G, Nelson JS (2007) Treatment of cutaneous vascular lesions using multiple-intermittent cryogen spurts and two-wavelength laser pulses: numerical and animal studies. Lasers Surg Med 39:494–503View Article
  12. Jia W, Tran N, Sun V et al (2012) Photocoagulation of dermal blood vessels with multiple laser pulses in an in vivo microvascular model. Lasers Surg Med 44(2):144–151View Article
  13. Li D, Li RH, Jia H, Chen B, Wu WJ, Yin ZX (2017) Experimental and numerical investigation on the transient vascular thermal response to multi-pulse Nd:YAG laser. Lasers Surg Med 49:852–865View Article
  14. Li D, Chen B, Wu WJ, Wang GX, He YL, Ying ZX (2014) Experimental investigation on the vascular thermal response to near-infrared laser pulses. Lasers Med Sci 30:135–145View Article
  15. Kimel S, Svaasand LO, Wilson MH, Schell MJ, Milner TE, Neslon JS, Berns MW (1994) Differential vascular response to laser photothermolysis. J Invest Dermatol 103(5):693–700View Article
  16. Kimel S, Svaasand LO, Cao D et al (2002) Vascular response to laser photothermolysis as a function of pulse duration, vessel type, and diameter: implications for port wine stain laser therapy. Lasers Surg Med 30(2):160–169View Article
  17. Kimel S, Svaasand LO, Hammer-Wilson MJ, Nelson JS (2003) Influence of wavelength on response to laser photothermolysis of blood vessels: implications for port wine stain laser therapy. Lasers Surg Med 33(5):288–295View Article
  18. Barton JK, Welch AJ, Izatt JA (1998) Investigating pulsed dye laser-blood vessel interaction with color Doppler optical coherence tomography. Opt Express 3(6):251–256View Article
  19. Barton JK, Frangineas G, Pummer H et al (2001) Cooperative phenomena in two-pulse, two-color laser photocoagulation of cutaneous blood vessels. Photochem Photobiol 73(6):642–650View Article
  20. Babilas P, Shafirstein G, Bäumler W, Baier J, Landthaler M, Szeimies R, Abels C (2005) Selective photothermolysis of blood vessels following flashlamp-pumped pulsed dye laser irradiation: in vivo results and mathematical modelling are in agreement. J Invest Dermatol 20(5):343–352View Article
  21. Furie B, Furie BC (2005) Thrombus formation in vivo. Clin Invest 115(12):3355–3362View Article
  22. Heger M (2013) Thrombosis versus thermal coagulum formation as a result of endovenous laser therapy: biochemistry versus photophysics, Phlebology, 2014. Vol. 29(10):701–705
  23. Heger M, Salles II, Bezemer R, Cloos MA, Mordon SR, Begu S, Deckmyn H, Beek JF (2011) Laser-induced primary and secondary hemostasis dynamics and mechanisms in relation to selective photothermolysis of port wine stains. J Dermatol Sci 63:139–147View Article
  24. Heger M, van Golen RF, Broekgaarden M, van den Bos RR, Neumann HA, van Gulik TM, van Gemert MJ (2014 Mar) Endovascular laser–tissue interactions and biological responses in relation to endovenous laser therapy. Lasers Med Sci 29(2):405–422View Article
  25. Black JF, Barton JK (2004) Chemical and structural changes in blood undergoing laser photocoagulation. Photochem Photobiol 80:89–97View Article
Metadata
Title
Thermal coagulum formation and hemostasis during repeated multipulse Nd:YAG laser treatment of cutaneous vascular lesions: animal experiment study
Authors
Dong Li
WenJuan Wu
Bin Chen
Zheming Gou
Penghui Zhao
GuoXiang Wang
Publication date
01-09-2020
Publisher
Springer London
Published in
Lasers in Medical Science / Issue 7/2020
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-020-03007-0

Other articles of this Issue 7/2020

Lasers in Medical Science 7/2020 Go to the issue

Original Article

Effect of the usage of Er,Cr:YSGG laser with and without different remineralization agents on the enamel erosion of primary teeth

Original Article

Clinical improvement of photoaging-associated facial hyperpigmentation in Korean skin with a picosecond 1064-nm neodymium-doped yttrium aluminum garnet laser

Original Article

Deciphering biophysical signatures for microbiological applications

Original Article

Evaluation of the effect of optic zone diameter selection on high-order aberrations in photorefractive keratectomy excimer laser treatment

Original Article

Attenuation of the inflammatory response and polarization of macrophages by photobiomodulation

Brief Report

Combined pulsed dye laser and systemic retinoids for the treatment of hypertrophic resistant warts among organ transplant patients