1/6. Imaging blood flow in human port-wine stain in situ and in real time using optical Doppler tomography.BACKGROUND: Optical Doppler tomography (ODT) combines laser Doppler flowmetry with optical coherence tomography to obtain high-resolution images of blood flow in human skin in situ and in real time. OBSERVATIONS: We present a case in which ODT was used on a patient with a port-wine stain (PWS) birthmark to document the change of blood flow in response to laser therapy. It might be possible to use ODT blood flow measurements in situ to assist in assessing the efficacy of laser PWS therapy. If partial restoration of flow occurs immediately or shortly after laser exposure, indicative of reperfusion due to inadequate blood vessel injury, the PWS can be retreated using higher light dosages. retreatment is continued until the measured Doppler shift is zero due to a permanent reduction in blood flow, indicative of irreversible microthrombus formation in the PWS vessels. CONCLUSIONS: We have demonstrated that ODT may be used for noninvasive imaging of blood vessels in PWS skin. Moreover, ODT will potentially allow laser therapy to be optimized on an individual patient basis by providing a fast, semiquantitative evaluation of the efficacy of PWS laser therapy in situ and in real time.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
2/6. Treatment of port wine stains using the pulsed-dye laser at 585 nm with the dynamic cooling device.Port wine stains (PWS) are common vascular malformations appearing more frequently on the face and neck. One of the most prevalent treatment modalities for PWS is the pulsed-dye laser (PDL). The first generation PDL was limited to a 450 microseconds pulse width which was inadequate for the treatment of larger caliber vessels. Second generation PDLs have pulsed widths approximately three times longer (1.5 ms). This, along with the dynamic cooling device (DCD), which allows the safe use of higher fluences, should result in more clinical improvement in the treatment of PWS that were previously resistant or minimally responsive to first generation PDL treatment. We report a case of a 29-year-old white male with extensive PWS on the left face, left neck, and back, which displayed only mild changes with the first generation PDL. However, the use of the 1.5 ms PDL at 585 nm at high fluences in conjunction with the DCD resulted in marked improvement of the patient's PWS.- - - - - - - - - - ranking = 0.038937089116741keywords = vessel (Clic here for more details about this article) |
3/6. Naevus anaemicus with teleangiectatic vessels.We describe a 20-year-old man with naevus anaemicus on the chest where, after dermabrasion of the epidermis, enlarged teleangiectatic dark-red vessels were seen within the previously pale area. They were clearly different from those seen on dermabrasion at this site in normal skin and in patients with vitiligo where the area is lighter red with only small punctual bleedings from arterial capillaries. The naevus anaemicus and a port-wine stain (naevus flammeus) in the same location is a phenomenon of vascular twin spotting, which was revealed when the epidermis was removed. The area was transplanted with thin epidermal grafts and healed within 2 weeks. One year later the naevus looked the same as before grafting. Much thicker grafts than those used by us will be needed, but they are not cosmetically acceptable.- - - - - - - - - - ranking = 0.19468544558371keywords = vessel (Clic here for more details about this article) |
4/6. hydranencephaly in an infant with vascular malformations.hydranencephaly is a condition in which cerebral hemispheres are absent and reduced to fluid-filled sacs in a normal skull. Numerous causes have been proposed. We report a male infant with hydranencephaly and congenital vascular malformations (port wine stains, generalized nevus flammeus, anomalous retinal vessels, and absent internal carotid flow). magnetic resonance imaging of the brain showed absence of most of the cerebrum except for small portions of the occipital cortex and thalami. magnetic resonance angiography showed flow within the vertebral and basilar arteries without internal carotid intracranial flow above the internal carotid petrous and cavernous portion. This is a report of cutaneous and retinal malformations associated with hydranencephaly. vascular malformations of larger vessels (e.g., webbing of the carotid arteries and an absent internal carotid arterial system) have been observed in other infants with hydranencephaly, and are proposed to lead to brain destruction. The case reported herein supports the role of primary vascular malformations in the development of some cases of hydranencephaly.- - - - - - - - - - ranking = 0.077874178233482keywords = vessel (Clic here for more details about this article) |
5/6. Three-dimensional reconstruction of port wine stain vascular anatomy from serial histological sections.Port wine stains (PWSs) treated with a flashlamp-pumped pulsed dye laser show a variability in clinical response that is incompletely understood. To identify any vascular structure that might adversely affect treatment response, we obtained a three-dimensional reconstruction of the vascular anatomy of a non-responsive, light-purple superficial PWS on the forearm. The reconstructed PWS consisted of multiple clusters of small diameter (10-50 microns) blood vessels. We propose that this and similar structures, which have not been identified in the literature, have limited the efficacy of laser therapy. Further study is required to clarify the role of vessel clusters for laser treatment of PWSs, and the corresponding dosimetry necessary to clear non-responsive lesions. We expect that three-dimensional reconstruction of PWS vascular anatomy will provide the basis for (i) accurate PWS classification, (ii) guidance for selection of more effective laser dosimetry, and (iii) a standard against which to assess non-invasive diagnostic imaging techniques.- - - - - - - - - - ranking = 0.51946854455837keywords = blood vessel, vessel (Clic here for more details about this article) |
6/6. Facial hypertrophic scarring from pulsed dye laser.BACKGROUND: The 585-nm, 450-msec pulsed dye laser is widely used to treat benign vascular lesions. The biophysical interactive properties of this laser allow effective, precise small vessel ablation with very low incidence of pigmentary alteration and atrophic scarring side effects. OBJECTIVE: We are reporting a case of hypertrophic scar development on the upper lip of a patient whose facial hypertrophic port-wine stain was treated by pulsed dye laser. methods: The most effective energy fluence was determined by analysis of test areas treated at various fluences. This fluence was used for the initial full lesion treatment, with subsequent fluences chosen by treatment response at each 4-week follow-up visit. RESULTS: After the fourth treatment a hypertrophic scar developed on our patient's left cutaneous upper lip. CONCLUSIONS: This hypertrophic scar developed after pulsed dye laser treatment because the patient did not follow posttreatment care instructions, and because the initial treatment fluences of 8.0-8.5 J/cm2 may have been too high.- - - - - - - - - - ranking = 0.038937089116741keywords = vessel (Clic here for more details about this article) |