Li D, Farshidi D, Wang G X, He Y L, Kelly K M, Wu W J, Chen B, Ying Z X
State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China.
Lasers Surg Med. 2014 Aug;46(6):479-87. doi: 10.1002/lsm.22250. Epub 2014 Jun 29.
Pulsed dye laser (PDL) is a commonly used treatment for Port Wine Stain birthmarks (PWS). However, deeper components of PWS are often resistant to PDL. Deeper penetrating lasers, including the long pulsed Neodymium:Yttrium Aluminum Garnet (Nd:YAG) laser have been used, but carry greater risk. This study evaluates the distinct blood vessel thermal responses to visible (595 nm) and near infrared (1,064 nm) lasers using animal and numerical models.
STUDY DESIGN/MATERIALS AND METHODS: Blood vessels in the rodent dorsal skin chamber (DSC) were irradiated by a 595 nm PDL and a long-pulsed 1,064 nm Nd:YAG laser. Laser-induced immediate and 1-hour post-structural and functional changes in the vessels were documented. Numerical simulations were conducted using a 1,000 µm depth SD mouse skin fold to simulate experimental conditions.
PDL irradiation produced immediate blood vessel hemorrhage. Modeling indicated this occurs due to preferential heating of the superior parts of large blood vessels. Nd:YAG irradiation resulted in blood vessel constriction; modeling indicated more uniform heating of vessel walls.
PDL and Nd:YAG lasers result in distinct tissue responses. This supports different observable clinical treatment end points when using these devices. Vessel constriction associated with the Nd:YAG may be more difficult to observe and is one reason this device may carry greater risk.
脉冲染料激光(PDL)是治疗葡萄酒色斑胎记(PWS)常用的方法。然而,PWS较深的部分通常对PDL有抗性。包括长脉冲钕:钇铝石榴石(Nd:YAG)激光在内的穿透性更强的激光已被使用,但风险更大。本研究使用动物模型和数值模型评估了可见(595nm)和近红外(1064nm)激光对血管产生的不同热反应。
研究设计/材料与方法:用595nm的PDL和长脉冲1064nm的Nd:YAG激光照射啮齿动物背部皮肤腔室(DSC)中的血管。记录激光诱导后血管立即出现的以及1小时后的结构和功能变化。使用深度为1000μm的SD小鼠皮肤褶皱进行数值模拟以模拟实验条件。
PDL照射导致血管立即出血。模型显示,这是由于大血管上部优先受热所致。Nd:YAG照射导致血管收缩;模型显示血管壁受热更均匀。
PDL和Nd:YAG激光会导致不同的组织反应。这支持了使用这些设备时不同的可观察到的临床治疗终点。与Nd:YAG相关的血管收缩可能更难观察到,这是该设备可能风险更大的一个原因。