Biomedical Engineering Reference
In-Depth Information
emphasized that IPL can be effective and safe in the treatment
of PWS only when used by an experienced operator.
LP 1064-nm Nd:YAG laser with epidermal cooling has also
successfully treated vascular lesions in darkly pigmented skin.
We have found that telangiectasias, both on the face and other
body areas, can be successfully treated using a 1064-nm laser
with a pulse duration of 25 ms, a 3.5-mm spot size, and fl uencies
between 200 and 250 J/cm
2
. This is usually given in combination
with dynamic cooling where a 30-ms cooling spray is given
coincident with the laser pulse. Utilizing these parameters, we
have not found epidermal hypopigmentation to occur. These
millisecond-domain 1064-nm lasers also offer a feasible treat-
ment option for vascular birthmarks and deep cutaneous vascu-
lar lesions in patients with darker skin phototypes (30,31). As
with the treatment of unwanted hair (as discussed later in this
chapter), the long-pulsed, 1064-nm laser with epidermal cool-
ing has become the laser of choice for the treatment of darkly
pigmented skin.
The introduction of combined 595- and 1064-nm laser has
also allowed for the treatment of recalcitrant and hypertrophic
(
A
)
(
B
)
(
C
)
(
D
)
(
E
)
Figure 13.2
A 9-year-old Thai girl with port-wine stain (
A
) before and (
B
) immediately after a 595-nm pulsed dye laser treatment with a DCD, treatments were
performed using a 7-mm spot size and a cryogen spurt duration of 80 ms, and a delay of 30 ms between spurt termination and onset of the laser pulse. The upper
half was treated with a fl uence of 8 J/cm
2
and a 0.45-ms pulse duration, whereas the lower half was treated with a fl uence of 15 J/cm
2
and a 40-ms pulsed duration.
(
C
) Two months after one treatment, the clearance rate corresponded to the extent of the postoperative purpura. (
D
) Two months after three treatments with the
same parameter. (
E
) Two months after the 13th treatment. During the fourth to sixth treatments, the whole lesion was treated at a fl uence of 8 J/cm
2
and a 0.45-ms
pulse duration, whereas the seventh to the 13th treatments were performed at a fl uence of 15 J/cm
2
and a 20-ms pulse duration. The DCD was set using the same
parameters.
Abbreviation
: DCD, dynamic cooling device.
