Rationale for automatic scanners in laser treatment of port wine stains

Abstract

Laser therapy of port wine stains (PWS) is well established. However, the application of lasers to PWS treatment over the last decade has resulted in the use of many laser systems. The goal of this study is to describe the different laser parameters, treatment techniques, and delivery systems. Two methods, coagulation and microvaporization, are used to destroy the abnormal blood vessels. The coagulation method results in excellent treatment, but it requires careful control of laser parameters during the treatment process. Scanning devices can be utilized for this purpose. The microvaporization method, obtained with a pulsed dye laser, is restricted to PWS composed of small vessels since it is difficult to obtain a pulse longer than 450 microseconds. In addition, numerous retreatments are needed with the pulsed dye method. The initial assessment of the patient should contribute to an improvement in the choice of laser parameters and the outcome of treatment.

Flashlamp pulsed dye laser and argon-pumped dye laser in the treatment of port-wine stains: a clinical and histological comparison. Dermatological Surgery and Lasers

“…The ideal pulse duration for PWS vessels may lie between 1 and 10 ms when the vessel diameter is 30–150 μm 14 . The argon‐pumped dye laser has a much longer pulse duration that results in coagulation, with non‐selective damage of the vessel wall, dermis and epidermis clinically expressed as skin blanching 15 . This perivascular collagen damage with fibrosis might contribute to substantial diminution of vessel diameter and prevent recanalization 16 .…”

Microsurgical laser scalpel based on spectroscopic feedback: the Smart Scalpel

“…It also allows longer endurance than humans in the same task. Many experts have demonstrated that the precise control of dosimetry is an important criteria for successful laser therapy [9]. Thus, automated treatment devices will surely improve the treatment results by using lasers in an optimal fashion.…”

“…Two categories of automated treatment devices have been developed: scanners and automated handpieces [9]. In the first category, the two systems developed are the MultiscanTM and the ScanalTM.…”

“…HexascanTM and CC-scanTM are automated handpieces controlled by a scanner mechanism composed of two stepper motors [9]. The motors are controlled by a microprocessor so they can be programmed to scan the laser across the treatment area in a variety of predefined patterns.…”

Clinical Usefulness of the Argon Laser for the 1990s

“…Regardless of the technique used, some of the major problems with the argon laser have been the lack of re‐producibility of the results, the fact that clinical outcome depends on the individual laser surgeon's technique, lack of homogeneous energy delivery, and the inability to treat large areas rapidly. These problems have recently been addressed with new scanners and automated hand‐pieces 10 . These instruments provide rapid, reproducible homogeneous laser treatment to large surface areas.…”