A practical comparison of Copper Bromide Laser for the treatment of vascular lesions

Keywords:surgical fibers, medical fiber optics,  Time:18-08-2016
Abstract — The  recent  rapid  growth  in  demand  for  aesthe tic  non - invasive    l aser treatments such  as    unwanted    skin  rejuvena tion, removal of age - related vascular blemishes has led  to  a  boom  in  the  medical  devices  to treat  these  conditions. Among diverse laser for skin treatment, c opper bromide laser is  a  very  effective,  safe,  and  well  tolerated  treatmen t  for  facial  telangiectasia  at various energy  levels and  the  most  important  thing of the copper  bromide laser  device is that the  stability of  the energy . However there  is no evidence about effective copper  bromide  laser ’ s  energy  level  for  the  treatment  of  vascular  lesions .    We    compared    energy    stability    and    treat ment performance between  two  energy  levels  in  2W  and  8W  which  commonly  use  in  laser  treatment  for  the  vascular lesions .  8W  copper  bromide  laser  was  more  stable  compare d than  2W  copper  bromide  laser.  A lso,  8W  copper  bromide  laser was  effectively superior to 2W copper bromide laser in treatment of  vascular   legion. Consequently ,   8W   copper  bromide   laser treatment  for  vascular  lesion  might  be  more  suitable  than  2W  copper bromide laser.
I. I NTRODUCTION The  yel low  laser  is  known  to  affect  epidermis  melanin,  vessel structures of degenerated corium, and epidermal VEGF  while showing antiangiogenic effects which are thought to aid  freckle treatment. According to a recent clinical research, the  manifestation     of     VEGF  within     keratogenesis     cells  significantly  diminished  after  copper  bromide  yellow  laser  (578nm) treatment, as the yellow laser affects the formation of  VEGF  and  corium  vessels  within  keratogenesis  cells,  while  inflammation   vehicles   directly   and   indirectly   af fect   the  formation of melanin, effectively treating freckles. C opper  bromide  laser  is  a  very  effective,  safe,  and  well  tolerated  treatment  for  facial  telangiectasia  at various energy  levels. (1) Also,     t he     potential     application     of    an  antiangiogenetic copper bromide  laser  for  the  treatment  of melasma specially accompanied by pronounced telangiectasia  in Asian skin is a possible treatment option. (2) B ut, t he copper  bromide  laser  is  less  suited  to  treating  very  small  vessel  lesions  such  as  diffuse  erythema,  an d  conversely  very  large  vessels as well as those of the nasal alae. (3) Generally,  copper  bromide  laser  was  an  effective  tool  in  the treatment of certain cutaneous vascular lesions. (4) And a 578  nm  copper  bromide  (CuBr)  yellow  light  laser  produces  excelle nt results in eradicating red telangiectases of the lower  extremities that are less than 2 mm in diameter.
However,   there   are   various   energy  levels for   laser  therapies .  A rgon  laser  (0.5  watt,  5  to  7  minutes  exposure)  fused  specimens  had  no  evidence  of  suture  material  at  the  anastomotic  line,  and  healing  consisted  of  a  bond  between  artery  and  vein  wall  tissues.  ( 6 )  And  a t  1  W,  the  tissue  was  desiccated  and  the  welds  disrupted  when  exposed  to  blood  flow ,  but a t  0.50  W,  the  fusion  failed  after  only  minimal exposure  to  the  laser  energy  because  of  tissue  drying  and  retraction  with  temperatures . ( 7 )  Nd:YAG  laser  1320  nm  (2  Watt, 20 seconds and 3 Watt, 8 seconds) via an applicator with  radial   symmetrical light   distribution   occlusion   of  recto  urogenital fistulae will  be  easier  to  achieve  since  fistula  occlusion. (8 ) Carbonization of the metallic tip and adherence  of atherosclerotic debris with secondary vessel tearing which  pulses  of  6  watts  were  delivered  to  the  laser  probe  were  potential  adverse  effects  of  the  laser  probe. ( 9 ) Laser with energy power of 8 - 10 watt irradiation a connective tissue scar  was  formed  substituting  the  defect  in  the  vascular  wall  and  covered  from  the  lumen  side with  a  thin  continuous  layer of  endothelium. ( 10 ) Radial heating  by  the  hot  t ip  probe using  a rgon   laser with   power   of 10   watts   can   cause   thermal  perforation. Blood flow or saline infusion modifies nontarget  heating and may offer significant protection to the vasculature. (1 1 ) P atients who underwent 15 watt laser angioplasty alone,  no   noticeable   improvement   in   distal   blood   flow  were demonstrated   by   doppler   velocimetry,   and   reocclusion  occurred  either  soon  afterwards  or  later.  (1 2 ) The  Coronary  laser balloon angioplasty system which consists of a 50 watt  continuous  wave  laser  has  been shown  to be  effective  in  the  management  of  acute  failure  of pressure  to  thermally  weld  tissue during coronary angioplasty.
T he  data  (la ser  output  energy)  concerning  the  normal  distribution and homogeneity of variance are shown in Table 1.  Total  606  data  from  the  copper  bromide  laser  output  energy  was  analyzed in 2W and 8W respectively. Both energy  level  were not satisfied with the require ments of normal distribution but  data  distribution  from  8W  energy  level  was  close  with  normal distribution(p=0.01) than 2W energy level and their p  value  were(p<0.001).  Also  their  data  variance  from  copper  bromide   energy   output   level   were  significant diffe rent  (P<0.001) surgical fibers