Landthaler 1986  Title: Neodymium-YAG laser therapy for vascular
lesions.
Author: Landthaler M, Haina D, Brunner R, Waidelich
W, Braun-Falco O
Journal: J Am Acad Dermatol 1986 Jan;14(1):107-17
PMID: 3753989, UI: 86140994
Affiliated institution:
Cited in:
Three patients with port-wine stains with a nodular surface,
one patient with macrocheilia resulting from a port-wine stain,
and one patient with a capillary hemangioma were treated with
a Nd-YAG laser (mediLas, MBB-AT, Munich). Irradiance was between
800 and 1,600 watts/cm2, with energy fluence between 400 and 1,600
joules/cm2. Treatments were performed with local anesthesia on
an outpatient basis. In all patients, marked improvements could
be obtained after only a few treatments. Histologically there
was necrosis of epidermis and dermis immediately after laser application,
and ectatic vessels contained coagulated erythrocytes. Depth of
coagulation was up to 3.5 mm. Quick restoration of epidermis was
observed. After some days, macrophages, fibroblasts, and capillary
blood vessels grew into the agglutination thrombi and ectatic
vessels were replaced by granulation tissue and, later, by fibrous
tissue. In comparison with the argon laser, the Nd-YAG laser coagulates
at a much deeper level, but processes of tissue repair take longer
and fibrosis is more pronounced after Nd-YAG laser application.
Clinically, therefore, scar formation is more likely. Chilling
the skin surface during irradiation and shorter exposure times
may be effective in reducing the risk of scar formation in the
future.
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