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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(05): 395-404
DOI: 10.1055/s-0043-1775871
Prof. Mira Sen (Banerjee) CME Article

Application of Lasers in Vascular Anomalies

Uddhav Anandrao Patil
1   Dr. D. Y. Patil Medical College and Hospital, Kolhapur, Maharashtra, India
2   LakshyaKiran Therapeutic Lasers and Research Institute Pvt. Ltd. Kolhapur, Maharashtra, India
3   Savitribai Phule Corporation Hospital, Kolhapur, Maharashtra, India
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Abstract

Laser technology has significantly improved giving better results, which in turn has led to an increase in the indications for laser therapy. Vascular anomalies comprise vascular tumors and malformations. They are classified according to the type of vessels involved including arteries, capillaries, postcapillary venules, veins, lymphatic vessels, and a combination of two or more of these. Laser needs a chromophore to get absorbed and act. Hemoglobin, both oxy and deoxy, is one of the naturally occurring chromophore that is abundant in vascular lesions. Therefore, in most of the vascular lesions, lasers can bring improvement of a varying degree, while for superficial hemangiomas and port wine stain (PWS) laser treatment is now the standard of care. However, even though there is increase in the use of lasers in clinical practice, many surgeons are still unaware of its versatility and they are unsure about its safety. This article provides a brief overview of laser and intense pulsed light (IPL) technology, and describes the key principles in using these energy sources in vascular malformations. Readers are also familiarized with possible adverse effects and measures to prevent and treat them.

Keywords

laser treatment - vascular malformations - vascular anomalies - vascular lasers - hemangioma

Declaration of Consent

The author has obtained consent of all patients to publish their photographs in this article.




Publication History

Article published online:
03 November 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Alster TS. Preface. In: Manual of Cutaneous Laser Techniques. Philadelphia, PA: Lippincott Williams and Wilkins; 2000: 11
    Google Scholar
  • 2 Geronemus RG. Pulsed dye laser treatment of vascular lesions in children. J Dermatol Surg Oncol 1993; 19 (04) 303-310
    CrossrefPubMedGoogle Scholar
  • 3 Azizkhan RG. Complex vascular anomalies. Pediatr Surg Int 2013; 29 (10) 1023-1038
    CrossrefPubMedGoogle Scholar
  • 4 Einstein A. Zur Quantentheorie der Strahlung. Physikalische Gesellschaft Zϋrich Miteilungen 1916; 18: 47-62 . Subsequently published in Physikalische Zeitschrift 1917;18:121–128. Reprinted in Kox AJ et al., eds. The collected papers of Albert Einstein: The Berlin Years, Writings, 1914–1917, Princeton: Princeton University Press, 1966:381–397. See also: Einstein A. Uber Einen die Erzeugung und Umwandlung des Lichts Betreffenden Heuristischen Standpunkt. Annalen der Physik 1905;17:132–184
    Google Scholar
  • 5 Dover JS, Arndt KA, Geronemus RG. et al. Illustrated Cutaneous Laser Surgery: A Practitioner's Guide. Norwalk, CT: Appleton & Lange; 1990
    Google Scholar
  • 6 Boulnois JL. Photophysical processes in recent medical laser developments: a review. Med Sci 1986; 1: 47-66
    Google Scholar
  • 7 Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 1983; 220 (4596) 524-527
    CrossrefPubMedGoogle Scholar
  • 8 Patil UA, Dhami LD. Overview of lasers. Indian J Plast Surg 2008; 41 (Suppl): S101-S113
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Anderson RR, Parrish JA. Microvasculature can be selectively damaged using dye lasers: a basic theory and experimental evidence in human skin. Lasers Surg Med 1981; 1 (03) 263-276
    CrossrefPubMedGoogle Scholar
  • 10 Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982; 69 (03) 412-422
    CrossrefPubMedGoogle Scholar
  • 11 ISSVA. Classification of Vascular Anomalies 2014 International Society for the Study of Vascular Anomalies. Accessed March 20, 2017 at: http://issva.org/classification
    Google Scholar
  • 12 Zhang B, Ma L. Updated classification and therapy of vascular malformations in pediatric patients. Pediatr Investig 2018; 2 (02) 119-123
    CrossrefPubMedGoogle Scholar
  • 13 Goldberg DJ. Laser treatment of vascular lesions. Clin Plast Surg 2000; 27 (02) 173-180 , ix
    CrossrefPubMedGoogle Scholar
  • 14 Dhami LD, Patil UA. Lasers and energy devices in plastic surgery. In: Agrawal K, Bhattacharya S. eds. Textbook of Plastic, Reconstructive, and Aesthetic Surgery. Vol. 1. Thieme; 2017: 401-428
    Google Scholar
  • 15 Goldberg DJ. ed. Laser Dermatology. Berlin: Springer-Verlag; 2013
    CrossrefGoogle Scholar
  • 16 Scherer K, Waner M. Nd:YAG lasers (1,064 nm) in the treatment of venous malformations of the face and neck: challenges and benefits. Lasers Med Sci 2007; 22 (02) 119-126
    CrossrefPubMedGoogle Scholar
  • 17 Astner S, Anderson RR. Treating vascular lesions. Dermatol Ther 2005; 18 (03) 267-281
    CrossrefPubMedGoogle Scholar
  • 18 Goldman MP, Eckhouse S. Photothermal sclerosis of leg veins. ESC Medical Systems, LTD Photoderm VL Cooperative Study Group. Dermatol Surg 1996; 22 (04) 323-330
    CrossrefPubMedGoogle Scholar
  • 19 DCD: Dynamic Cooling Devices is a trademark of Candela, which sprays the treatment area before each laser pulse with a liquid cryogen coolant. This system provides a cooling protection factor over 50% greater than contact or air cooling and can be adjusted to individual needs to make the procedure as comfortable as possible.
  • 20 McRae MY, Adams S, Pereira J, Parsi K, Wargon O. Venous malformations: Clinical course and management of vascular birthmark clinic cases. Australas J Dermatol 2013; 54 (01) 22-30
    CrossrefPubMedGoogle Scholar
  • 21 Galich SP, Dabizha AIu, Gindich OA. et al. Combined treatment of arteriovenous malformations of the head and neck. Angiol Sosud Khir 2015; 21 (01) 170-177
    PubMedGoogle Scholar
  • 22 Johnson CM, Navarro OM. Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 2: vascular malformations. Pediatr Radiol 2017; 47 (09) 1196-1208
    CrossrefPubMedGoogle Scholar
  • 23 Balakrishnan K, Edwards TC, Perkins JA. Functional and symptom impacts of pediatric head and neck lymphatic malformations: developing a patient-derived instrument. Otolaryngol Head Neck Surg 2012; 147 (05) 925-931
    CrossrefPubMedGoogle Scholar