Vivek Sivarajan1, Iain R Mackay. 1. Canniesburn Plastic Surgery Unit, Switchback Road Bearsden, Glasgow G61 1QL, United Kingdom. viveksivarajan@hotmail.com
Abstract
BACKGROUND AND OBJECTIVES: The response of capillary vascular malformations (CVMs) to laser treatment is believed to be due to the pattern of capillary ectasia, the depth, diameter, and flow through these capillaries and the amount of competing chromophores within the skin. Videomicroscopy has successfully been used to determine CVM capillary pattern and diameter of vessels. The depth measuring videomicroscope (DMV) allows the depth of capillaries to be measured also. The aim of this study is to examine how capillary depths within a CVM are affected by dye laser treatment using DMV. STUDY DESIGN/ MATERIALS AND METHODS: Thirteen previously untreated patients were examined in a temperature-controlled room. A DMV examination was carried out prior to and 6 weeks following a treatment with pulsed dye laser. A further cohort of 11 resistant CVM patients, who had all received over five treatments, was also examined for comparison. RESULTS: Using a Wilcoxon Signed rank test, the results showed that the remaining vessels within the CVM as measured using DMV were more deeply located and smaller (P < 0.01 and P < 0.02 respectively), following the laser treatment. Also in the resistant patients the vessels were again more deeply placed and smaller. CONCLUSIONS: The hypothesis that smaller and more deeply placed CVM vessels respond poorest to laser treatment is supported by these findings. Moreover, the DMV provides a simple non-invasive technique for demonstrating this. Copyright 2004 Wiley-Liss, Inc.
BACKGROUND AND OBJECTIVES: The response of capillary vascular malformations (CVMs) to laser treatment is believed to be due to the pattern of capillary ectasia, the depth, diameter, and flow through these capillaries and the amount of competing chromophores within the skin. Videomicroscopy has successfully been used to determine CVM capillary pattern and diameter of vessels. The depth measuring videomicroscope (DMV) allows the depth of capillaries to be measured also. The aim of this study is to examine how capillary depths within a CVM are affected by dye laser treatment using DMV. STUDY DESIGN/ MATERIALS AND METHODS: Thirteen previously untreated patients were examined in a temperature-controlled room. A DMV examination was carried out prior to and 6 weeks following a treatment with pulsed dye laser. A further cohort of 11 resistant CVM patients, who had all received over five treatments, was also examined for comparison. RESULTS: Using a Wilcoxon Signed rank test, the results showed that the remaining vessels within the CVM as measured using DMV were more deeply located and smaller (P < 0.01 and P < 0.02 respectively), following the laser treatment. Also in the resistant patients the vessels were again more deeply placed and smaller. CONCLUSIONS: The hypothesis that smaller and more deeply placed CVM vessels respond poorest to laser treatment is supported by these findings. Moreover, the DMV provides a simple non-invasive technique for demonstrating this. Copyright 2004 Wiley-Liss, Inc.