Effectiveness of dual sequential wavelength laser in the treatment of portwine stains – A retrospective study

Abstract

Background: Port Wine Stain (PWS) is only partially and superficially treated with the Pulsed dye laser (PDL) because of its limited depth of penetration. The 1064-nm long pulsed Nd:YAG laser has greater depth of penetration and is used to treat deeper vessels. The dual sequential wavelength laser (DSWL) which combines PDL/Nd:YAG (595/1064 nm) can be more effective for the treatment of deeper, nodular portwine stains due to its synergistic effect. The purpose of this study is to evaluate the efficacy and safety of DSWL in the treatment of portwine stains after five treatment sessions. Materials and Methods: A total of 11 patients with PWS lesions on the head and neck, who were treated with DSWL for at least five sittings at monthly interval were included in this study. The assessment of the therapeutic response and grading of improvement was done with a scale of 0 to 4 by comparing the photographs taken before treatment and after 5 sittings of laser treatment. Results: Out of the 11 patients, 5 patients (45.45%) had more than 70% improvement. Six out of eleven patients (54.54%) had 40 to 70% improvement at the end of five sittings with no adverse effects including purpura. Conclusion: Dual Sequential Wavelength Laser is a good modality of treatment for portwine stains. It has enhanced penetration and effective clearance of thicker, nodular, recalcitrant lesions of PWS. DSWL is safe and efficacious and it can be recommended as a therapeutic modality for portwine stains.

The Cost-Effectiveness of Pulsed-Dye Laser Therapy Among Thai Patients with Facial Port-Wine Stain: A Retrospective Study and Economic Evaluation

“…In our study, we also reported that the use of a combination wavelength (585 nm PDL with long pulsed QS 1064 nm) to treat PWS can significantly improve the clinical outcome by 6.52% when compared to using PDL wavelength alone. This finding was consistent with previous studies as well [19][20][21]. The PDL energy converts hemoglobin to methemoglobin, while the 1064 nm energy is absorbed more by methemoglobin leading to better clinical clearance [22].…”

Acquired digital arteriovenous malformation successfully treated with long‐pulsed 1.064 nm neodymium‐doped yttrium aluminum garnet (Nd: YAG ) laser

“…The Multiplex laser is a dual sequential wavelength laser that emits two wavelengths, 595 and 1064 nm, from the same delivery fiber with a preselected delay between the two pulses permitting the coagulation of superficial and deep structures. 5 Moreover, PDL reduces oxyhaemoglobin to methaemoglobin, increasing the absorption by Nd:YAG laser and allowing the use of low fluences with decreasing of complications. 5 The main side effects of laser treatment are pain, bleeding, necrosis, and atrophic scarring.…”

“…5 Moreover, PDL reduces oxyhaemoglobin to methaemoglobin, increasing the absorption by Nd:YAG laser and allowing the use of low fluences with decreasing of complications. 5 The main side effects of laser treatment are pain, bleeding, necrosis, and atrophic scarring. 2 To conclude, laser treatment is a safe and effective option for ADAVMs, especially those nonpulsatile and without cutaneous dystrophic changes.…”