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Influence of wavelength on response to laser photothermolysis of blood vessels: Implications for port wine stain laser therapy

Background and Objective Treatment of port wine stains (PWS) by photothermolysis can be improved by optimizing laser parameters. We have studied the all‐important role of wavelength (λ) by performing pulsed laser photothermolysis in the vasculature of the chick chorioallantoic membrane (CAM) assay....

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Published in:Lasers in surgery and medicine 2003-01, Vol.33 (5), p.288-295
Main Authors: Kimel, Sol, Svaasand, Lars O., Hammer-Wilson, Marie J., Nelson, J. Stuart
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description Background and Objective Treatment of port wine stains (PWS) by photothermolysis can be improved by optimizing laser parameters. We have studied the all‐important role of wavelength (λ) by performing pulsed laser photothermolysis in the vasculature of the chick chorioallantoic membrane (CAM) assay. Study Design/Materials and Methods The CAM contains an extensive microvascular network ranging from capillaries with diameter D 
doi_str_mv 10.1002/lsm.10224
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Stuart</creator><creatorcontrib>Kimel, Sol ; Svaasand, Lars O. ; Hammer-Wilson, Marie J. ; Nelson, J. Stuart</creatorcontrib><description>Background and Objective Treatment of port wine stains (PWS) by photothermolysis can be improved by optimizing laser parameters. We have studied the all‐important role of wavelength (λ) by performing pulsed laser photothermolysis in the vasculature of the chick chorioallantoic membrane (CAM) assay. Study Design/Materials and Methods The CAM contains an extensive microvascular network ranging from capillaries with diameter D &lt; 20 μm to blood vessels of D ≈ 120 μm. The CAM assay enables observation and real‐time video documentation of blood flow in pre‐capillary arterioles (A) and post‐capillary venules (V). The ScleroPlus™ laser (Candela Corp., Wayland, MA) has a smooth output over its fixed 1.5 ms pulse duration and allows the operator to vary several treatment parameters such as wavelength, spot size, and energy. Blood vessels in the CAM were irradiated at two clinically relevant wavelengths, λ = 587 or 597 nm, constant spot size (7 mm), and at different exposures (E = 5–12 J/cm2). Threshold exposure (Eth) (at which non‐reversible damage occurred) were 5 J/cm2 at 587 nm and 8 J/cm2 at 597 nm. Mathematical modeling was developed to interpret initial (within 30 seconds) injury of arterioles and venules at both wavelengths as a function of D when varying E. Results Vessel injury was graded off‐line from videotapes. For all combinations of λ and E, measurable injury was evident within 30 seconds of irradiation and maximal damage was reached in less than 10 minutes. Vessel damage was found to depend strongly on λ. Damage decreased with increasing vessel size. For all D, damage of arterioles was greater than for corresponding venules. Conclusions Selection of the correct wavelength is crucial for successful laser therapy of hypervascular lesions and, ideally, should be based on knowledge of vessel diameters for a specific PWS lesion and of optical penetration depths in blood. As a general statement, smaller blood vessels (D = 10–60 μm) should be treated using shorter wavelengths such as 585 nm. To ensure deposition of sufficient laser energy, irradiation at 585 nm, characterized by lower optical penetration depth in blood, may be preferable for PWS therapy. Lasers Surg. Med. 33:288–295, 2003. © 2003 Wiley‐Liss, Inc.</description><identifier>ISSN: 0196-8092</identifier><identifier>EISSN: 1096-9101</identifier><identifier>DOI: 10.1002/lsm.10224</identifier><identifier>PMID: 14677156</identifier><identifier>CODEN: LSMEDI</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Animals ; arterioles ; Biological and medical sciences ; Blood Vessels - radiation effects ; Chick Embryo ; chorioallantoic membrane (CAM) ; Humans ; Laser Therapy - methods ; Medical sciences ; Models, Animal ; Models, Cardiovascular ; Photolysis - radiation effects ; Phototherapy - methods ; port wine stain ; Port-Wine Stain - therapy ; Radiation ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; skin ; Technology. Biomaterials. Equipments. Material. Instrumentation ; Vascular Surgical Procedures - methods ; venules</subject><ispartof>Lasers in surgery and medicine, 2003-01, Vol.33 (5), p.288-295</ispartof><rights>Copyright © 2003 Wiley‐Liss, Inc.</rights><rights>2004 INIST-CNRS</rights><rights>Copyright 2003 Wiley-Liss, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4204-72d7aa7226867b86790cd7303d09c4ca93324d2e23e8818aacabf1b6a051815a3</citedby><cites>FETCH-LOGICAL-c4204-72d7aa7226867b86790cd7303d09c4ca93324d2e23e8818aacabf1b6a051815a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=15357776$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14677156$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kimel, Sol</creatorcontrib><creatorcontrib>Svaasand, Lars O.</creatorcontrib><creatorcontrib>Hammer-Wilson, Marie J.</creatorcontrib><creatorcontrib>Nelson, J. Stuart</creatorcontrib><title>Influence of wavelength on response to laser photothermolysis of blood vessels: Implications for port wine stain laser therapy</title><title>Lasers in surgery and medicine</title><addtitle>Lasers Surg. Med</addtitle><description>Background and Objective Treatment of port wine stains (PWS) by photothermolysis can be improved by optimizing laser parameters. We have studied the all‐important role of wavelength (λ) by performing pulsed laser photothermolysis in the vasculature of the chick chorioallantoic membrane (CAM) assay. Study Design/Materials and Methods The CAM contains an extensive microvascular network ranging from capillaries with diameter D &lt; 20 μm to blood vessels of D ≈ 120 μm. The CAM assay enables observation and real‐time video documentation of blood flow in pre‐capillary arterioles (A) and post‐capillary venules (V). The ScleroPlus™ laser (Candela Corp., Wayland, MA) has a smooth output over its fixed 1.5 ms pulse duration and allows the operator to vary several treatment parameters such as wavelength, spot size, and energy. Blood vessels in the CAM were irradiated at two clinically relevant wavelengths, λ = 587 or 597 nm, constant spot size (7 mm), and at different exposures (E = 5–12 J/cm2). Threshold exposure (Eth) (at which non‐reversible damage occurred) were 5 J/cm2 at 587 nm and 8 J/cm2 at 597 nm. Mathematical modeling was developed to interpret initial (within 30 seconds) injury of arterioles and venules at both wavelengths as a function of D when varying E. Results Vessel injury was graded off‐line from videotapes. For all combinations of λ and E, measurable injury was evident within 30 seconds of irradiation and maximal damage was reached in less than 10 minutes. Vessel damage was found to depend strongly on λ. Damage decreased with increasing vessel size. For all D, damage of arterioles was greater than for corresponding venules. Conclusions Selection of the correct wavelength is crucial for successful laser therapy of hypervascular lesions and, ideally, should be based on knowledge of vessel diameters for a specific PWS lesion and of optical penetration depths in blood. As a general statement, smaller blood vessels (D = 10–60 μm) should be treated using shorter wavelengths such as 585 nm. To ensure deposition of sufficient laser energy, irradiation at 585 nm, characterized by lower optical penetration depth in blood, may be preferable for PWS therapy. Lasers Surg. Med. 33:288–295, 2003. © 2003 Wiley‐Liss, Inc.</description><subject>Animals</subject><subject>arterioles</subject><subject>Biological and medical sciences</subject><subject>Blood Vessels - radiation effects</subject><subject>Chick Embryo</subject><subject>chorioallantoic membrane (CAM)</subject><subject>Humans</subject><subject>Laser Therapy - methods</subject><subject>Medical sciences</subject><subject>Models, Animal</subject><subject>Models, Cardiovascular</subject><subject>Photolysis - radiation effects</subject><subject>Phototherapy - methods</subject><subject>port wine stain</subject><subject>Port-Wine Stain - therapy</subject><subject>Radiation</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>skin</subject><subject>Technology. Biomaterials. Equipments. Material. Instrumentation</subject><subject>Vascular Surgical Procedures - methods</subject><subject>venules</subject><issn>0196-8092</issn><issn>1096-9101</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNqFkU1v1DAQhi0EokvhwB9AvoDEIdQfSZxwqypoV1oWJEBFXCzHmbAGJw6ebJe98NvxsoGeEAfLc3ied6R5CXnM2QvOmDjz2KdBiPwOWXBWl1nNGb9LFoynuWK1OCEPEL8yxqRg6j454XmpFC_KBfm5HDq_hcECDR3dmRvwMHyZNjQMNAKOYUCgU6DeIEQ6bsIUpg3EPvg9Ojw4jQ-hpTeACB5f0mU_emfN5JJJu5CcECe6cwNQnIwb5qRDiBn3D8m9zniER_N_Sj6-fvXh4ipbvb1cXpyvMpsLlmdKtMoYJURZlapJr2a2VZLJltU2t6aWUuStACGhqnhljDVNx5vSsIJXvDDylDw75o4xfN8CTrp3aMF7M0DYolbpIpyX1X9BXgtRVKVI4PMjaGNAjNDpMbrexL3mTB9a0akV_buVxD6ZQ7dND-0tOdeQgKczYNAa30UzWIe3XCELpdSBOztyO-dh_--NevX-zZ_V2dFwOMGPv4aJ33SppCr09fpSv1tfX4nP61x_kr8AQUS0jA</recordid><startdate>20030101</startdate><enddate>20030101</enddate><creator>Kimel, Sol</creator><creator>Svaasand, Lars O.</creator><creator>Hammer-Wilson, Marie J.</creator><creator>Nelson, J. Stuart</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20030101</creationdate><title>Influence of wavelength on response to laser photothermolysis of blood vessels: Implications for port wine stain laser therapy</title><author>Kimel, Sol ; Svaasand, Lars O. ; Hammer-Wilson, Marie J. ; Nelson, J. Stuart</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4204-72d7aa7226867b86790cd7303d09c4ca93324d2e23e8818aacabf1b6a051815a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Animals</topic><topic>arterioles</topic><topic>Biological and medical sciences</topic><topic>Blood Vessels - radiation effects</topic><topic>Chick Embryo</topic><topic>chorioallantoic membrane (CAM)</topic><topic>Humans</topic><topic>Laser Therapy - methods</topic><topic>Medical sciences</topic><topic>Models, Animal</topic><topic>Models, Cardiovascular</topic><topic>Photolysis - radiation effects</topic><topic>Phototherapy - methods</topic><topic>port wine stain</topic><topic>Port-Wine Stain - therapy</topic><topic>Radiation</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>skin</topic><topic>Technology. Biomaterials. Equipments. Material. Instrumentation</topic><topic>Vascular Surgical Procedures - methods</topic><topic>venules</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kimel, Sol</creatorcontrib><creatorcontrib>Svaasand, Lars O.</creatorcontrib><creatorcontrib>Hammer-Wilson, Marie J.</creatorcontrib><creatorcontrib>Nelson, J. 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Stuart</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of wavelength on response to laser photothermolysis of blood vessels: Implications for port wine stain laser therapy</atitle><jtitle>Lasers in surgery and medicine</jtitle><addtitle>Lasers Surg. Med</addtitle><date>2003-01-01</date><risdate>2003</risdate><volume>33</volume><issue>5</issue><spage>288</spage><epage>295</epage><pages>288-295</pages><issn>0196-8092</issn><eissn>1096-9101</eissn><coden>LSMEDI</coden><abstract>Background and Objective Treatment of port wine stains (PWS) by photothermolysis can be improved by optimizing laser parameters. We have studied the all‐important role of wavelength (λ) by performing pulsed laser photothermolysis in the vasculature of the chick chorioallantoic membrane (CAM) assay. Study Design/Materials and Methods The CAM contains an extensive microvascular network ranging from capillaries with diameter D &lt; 20 μm to blood vessels of D ≈ 120 μm. The CAM assay enables observation and real‐time video documentation of blood flow in pre‐capillary arterioles (A) and post‐capillary venules (V). The ScleroPlus™ laser (Candela Corp., Wayland, MA) has a smooth output over its fixed 1.5 ms pulse duration and allows the operator to vary several treatment parameters such as wavelength, spot size, and energy. Blood vessels in the CAM were irradiated at two clinically relevant wavelengths, λ = 587 or 597 nm, constant spot size (7 mm), and at different exposures (E = 5–12 J/cm2). Threshold exposure (Eth) (at which non‐reversible damage occurred) were 5 J/cm2 at 587 nm and 8 J/cm2 at 597 nm. Mathematical modeling was developed to interpret initial (within 30 seconds) injury of arterioles and venules at both wavelengths as a function of D when varying E. Results Vessel injury was graded off‐line from videotapes. For all combinations of λ and E, measurable injury was evident within 30 seconds of irradiation and maximal damage was reached in less than 10 minutes. Vessel damage was found to depend strongly on λ. Damage decreased with increasing vessel size. For all D, damage of arterioles was greater than for corresponding venules. Conclusions Selection of the correct wavelength is crucial for successful laser therapy of hypervascular lesions and, ideally, should be based on knowledge of vessel diameters for a specific PWS lesion and of optical penetration depths in blood. As a general statement, smaller blood vessels (D = 10–60 μm) should be treated using shorter wavelengths such as 585 nm. To ensure deposition of sufficient laser energy, irradiation at 585 nm, characterized by lower optical penetration depth in blood, may be preferable for PWS therapy. Lasers Surg. Med. 33:288–295, 2003. © 2003 Wiley‐Liss, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>14677156</pmid><doi>10.1002/lsm.10224</doi><tpages>8</tpages></addata></record>
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subjects Animals
arterioles
Biological and medical sciences
Blood Vessels - radiation effects
Chick Embryo
chorioallantoic membrane (CAM)
Humans
Laser Therapy - methods
Medical sciences
Models, Animal
Models, Cardiovascular
Photolysis - radiation effects
Phototherapy - methods
port wine stain
Port-Wine Stain - therapy
Radiation
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
skin
Technology. Biomaterials. Equipments. Material. Instrumentation
Vascular Surgical Procedures - methods
venules
title Influence of wavelength on response to laser photothermolysis of blood vessels: Implications for port wine stain laser therapy
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