Treatment of leg veins with the long pulse dye laser using variable pulse durations and energy fluences
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Abstract Background and Objectives Attempts at using the pulsed dye laser (PDL) operating at 585 nm wavelength and 0.45 milliseconds pulse duration to treat leg veins have been notably unsuccessful. The aim of this study is to evaluate the efficacy and complications of the 595 nm long PDL in the treatment of leg veins. Study Design/Patients and Methods Fourteen patients with 38 lesions were treated using a long PDL equipped with a cryogen spray cooling (CSC) device. Variable pulse durations ranging from 1.5 to 20 milliseconds and energy fluences from 10 to 20 J/cm 2 were utilized depending on the size of treated vessels. All patients received two laser treatments at an interval of 2 months. Results Of patients with veins type 1A and type 1, 6 (100%) and 3 (13%) had complete clearing, respectively. Of patients with veins type 1 and type 2, 18 (78.3%) and 2 (22.2%) lesions showed excellent response, respectively. Hyperpigmentation was the only observed complication lasting several months in 57.9% of treated sites. Conclusions The long PDL operating at 595 nm is a safe and effective treatment for leg veins, especially in type 1A and type1 vessels. Lasers Surg. Med. 35:62–67, 2004. © 2004 Wiley‐Liss, Inc.Keywords:
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Telangiectases
Port wine
Port-wine stain
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Port-wine stains respond quite well to 585 nm pulsed dye laser treatment, but often clearance is not complete. We investigated a prototype, a high-energy 595 nm pulsed dye laser capable of delivering up to 9.5 J/cm2 using a 10 mm circular spot, with a 1.5 ms pulse duration.This study was undertaken to determine if the high-energy, 595 nm, variable-pulse duration pulsed dye laser could improve port-wine stains that had become refractory to conventional treatment.Twenty patients were entered into the study and treated with the high-energy, 595 nm, variable-pulse duration pulsed dye laser using fluences ranging from 7.5 to 9.5 J/cm2, a 1.5 ms pulse duration, and a 10 mm spot size.Average improvement was rated as 40% prior to the initiation of the study after an average of 8.8 treatments at an average energy of 7.9 J/cm2 with the 585 nm pulsed dye laser and 76% following an average of 3.1 treatments with the high-energy 595 nm pulsed dye laser using an average fluence of 7.9 J/cm2. Dermal spectrometer erythema measurements improved from 2.2-fold that of normal skin to 1.5-fold that of unaffected skin.The high-energy 595 nm pulsed dye laser improves port-wine stains that have become refractory to the conventional 585 nm pulsed dye laser.
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Abstract Background and Objectives Pulsed dye lasers (PDL) with extended pulse‐durations create new opportunities in the treatment of vascular lesions. Development of extended pulse methods requires understanding of tissue effects of extended pulse‐durations. We evaluated tissue effects of extended pulse‐duration PDL (EPDL) with cooling. Effects of increasing pulse‐duration, fluence, and multiple passes were evaluated to determine purpuric threshold and delayed purpuric response. Study Design/Patients and Methods Ten patients were treated with EPDL and air‐cooling on normal buttocks skin. Exposure pulse‐durations of 0.5, 2, 20, and 40 milliseconds and increasing fluences 3–20 J/cm 2 , pulse‐duration dependent. Exposures were evaluated 0.5, 1, and 24 or 48 hours determining purpuric threshold and side effects. Results Immediate purpuric threshold increased from 6.2 to 8, 10.4, and 13.8 J/cm 2 at pulse‐durations of 0.5, 2, 20, and 40 milliseconds, respectively. Purpuric threshold dropped after 24 hours to 5.2, 7.1, 9.3, and 11.9 J/cm 2 , respectively. Multi‐pass treatment lowered purpuric threshold by 1 J/cm 2 . EPDL purpura resolved in less time than traditional PDL. No side effects were noted. Conclusions EPDL exhibits increasing purpuric threshold with increasing pulse‐durations, and risk of delayed onset of purpura. Lasers Surg. Med. 31:363–366, 2002. © 2002 Wiley‐Liss, Inc.
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BACKGROUND The 595-nm pulsed dye laser has been the standard of care for many vascular lesions and has rarely been used in the treatment of epidermal pigmented lesions. OBJECTIVE The objective was to investigate the effectiveness and safety of a compression technique for the treatment of epidermal pigmented lesion using a modified 595-nm pulsed dye laser with no epidermal cooling. METHODS Twelve subjects (mean age 58 years) underwent treatments using a modified 595-nm dye laser with a compression handpiece and no epidermal cooling. Treatments were performed with radiant exposures of 7 to 12 J/cm2, 7-mm spot size, and 1.5-ms pulse duration. Each subject received one to four treatments, 4 to 6 weeks apart. Follow-up evaluations were held before each treatment and 4 months after last treatment. RESULTS Clearance of 75% to 100% was obtained in 43, 59, 76, and 79% of the lesions treated after one, two, three, and four treatments respectively. The fourth treatment was evaluated 4 months posttreatment. Side effects included immediate erythema and edema and rare cases of transient hyperpigmentation and atrophy. No purpura and long-lasting side effects were observed. CONCLUSION The compression technique with a modified 595-nm pulsed dye laser system is effective and safe for the treatment of epidermal pigmented lesions.
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The mechanism of HPM pulse duration damage effect on semiconductor component results from heat accumulation and diffusion process in the defect area. The experiential formulae of HPM pulse duration damage effect in the range of whole pulse durarion, long pulse duration as well as short pulse duration are obtained, which agree with experiments and numerical simulation effect data very well.
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BACKGROUND The 595-nm pulsed dye laser has been the standard of care for many vascular lesions and has rarely been used in the treatment of epidermal pigmented lesions. OBJECTIVE The objective was to investigate the effectiveness and safety of a compression technique for the treatment of epidermal pigmented lesion using a modified 595-nm pulsed dye laser with no epidermal cooling. METHODS Twelve subjects (mean age 58 years) underwent treatments using a modified 595-nm dye laser with a compression handpiece and no epidermal cooling. Treatments were performed with radiant exposures of 7 to 12 J/cm2, 7-mm spot size, and 1.5-ms pulse duration. Each subject received one to four treatments, 4 to 6 weeks apart. Follow-up evaluations were held before each treatment and 4 months after last treatment. RESULTS Clearance of 75% to 100% was obtained in 43, 59, 76, and 79% of the lesions treated after one, two, three, and four treatments respectively. The fourth treatment was evaluated 4 months posttreatment. Side effects included immediate erythema and edema and rare cases of transient hyperpigmentation and atrophy. No purpura and long-lasting side effects were observed. CONCLUSION The compression technique with a modified 595-nm pulsed dye laser system is effective and safe for the treatment of epidermal pigmented lesions.
Erythema
Hypopigmentation
Purpura (gastropod)
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BACKGROUND Port-wine stains respond quite well to 585 nm pulsed dye laser treatment, but often clearance is not complete. We investigated a prototype, a high-energy 595 nm pulsed dye laser capable of delivering up to 9.5 J/cm2 using a 10 mm circular spot, with a 1.5 ms pulse duration. OBJECTIVE This study was undertaken to determine if the high-energy, 595 nm, variable-pulse duration pulsed dye laser could improve port-wine stains that had become refractory to conventional treatment. METHODS Twenty patients were entered into the study and treated with the high-energy, 595 nm, variable-pulse duration pulsed dye laser using fluences ranging from 7.5 to 9.5 J/cm2, a 1.5 ms pulse duration, and a 10 mm spot size. RESULTS Average improvement was rated as 40% prior to the initiation of the study after an average of 8.8 treatments at an average energy of 7.9 J/cm2 with the 585 nm pulsed dye laser and 76% following an average of 3.1 treatments with the high-energy 595 nm pulsed dye laser using an average fluence of 7.9 J/cm2. Dermal spectrometer erythema measurements improved from 2.2-fold that of normal skin to 1.5-fold that of unaffected skin. CONCLUSIONS The high-energy 595 nm pulsed dye laser improves port-wine stains that have become refractory to the conventional 585 nm pulsed dye laser.
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Port-wine stain
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Intense pulsed light
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The results of numerical simulations of elongating the pulse duration of a TEA CO 2 laser are reported. It is shown that neither relative increase of N 2 gas in the N 2 :He:CO 2 gas mixture nor elongation of the pulse duration of the discharge current is very effective. A significant result is obtained with the pulse injection locking method, when the following two conditions are satisfied: 1) the detuning angle is less than 0.1π, and 2) the initiation of discharge of the main laser is synchronized with the injected laser pulse within about 200 ns.
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