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Lasers Surg Med. 2015 Aug;47(6):469-75. doi: 10.1002/lsm.22369. Epub 2015 Jun 3.

Intraoperative, real-time monitoring of blood flow dynamics associated with laser surgery of port wine stain birthmarks.

Yang B1,2, Yang O1,2, Guzman J1,2, Nguyen P1,2, Crouzet C, Osann KE3, Kelly KM1,4, Nelson JS1,2,3,4,5, Choi B1,2,5,6.

Author information

1
Beckman Laser Institute and Medical Clinic, University of California, Irvine, California 92612.
2
Department of Biomedical Engineering, University of California, Irvine, California 92697.
3
Division of Hematology/Oncology, School of Medicine, University of California, Irvine, California 92697.
4
Department of Dermatology, University of California, Irvine, California 92697.
5
Department of Surgery, University of California, Irvine, California 92697.
6
Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine, California 92697.

Abstract

BACKGROUND AND OBJECTIVE:

Port-wine stain (PWS) birthmarks affect ∼22 million people worldwide. After several treatment sessions, complete disappearance of the PWS occurs in only ∼10% of treated patients. There is a need to develop a new strategy to improve the efficacy of each treatment session and the overall treatment outcome. The study objective was to determine how intraoperative measurements of blood flow correlate with treatment response assessed several weeks post treatment.

STUDY DESIGN/MATERIALS AND METHODS:

We employed Laser Speckle Imaging (LSI) to measure intraoperative blood-flow dynamics. We collected data from 24 subjects undergoing laser therapy for facial PWS birthmarks. Photographs were taken before treatment and at a follow-up visit, and analyzed by two expert observers.

RESULTS:

Intraoperative LSI enables real-time monitoring of blood-flow dynamics in response to laser treatment and can inform clinicians on the need for focused re-treatment. The degree of PWS blanching achieved is positively correlated with the log-transformed acute blood-flow reduction (P = 0.022).

CONCLUSION:

LSI is a simple, intraoperative monitoring tool during laser therapy of PWS birthmarks. LSI provides a single value for blood flow that correlates well with the degree of blanching achieved with laser therapy.

KEYWORDS:

blood perfusion; laser Doppler; optical imaging; pulsed dye laser; speckle contrast

PMID:
26040983
PMCID:
PMC4535813
DOI:
10.1002/lsm.22369
[Indexed for MEDLINE]
Free PMC Article

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