Cryogen Spray Cooling during Nd:YAG Laser Treatment of Hemangiomas.

BACKGROUND. Successful laser treatment of hemangiomas requires selective photothermal destruction of dilated cutaneous vessels without damaging the overlying epidermis. Delivering a short cryogen spurt, on the order of milliseconds, has been shown to result in localized cooling of the superficial skin structures during laser irradiation. OBJECTIVE.The purpose of this study was to examine the effectiveness of cryogen spray cooling (CSC) in protecting superficial tissue structures during continuous Nd:YAG laser irradiation of an in vivo model hemangioma. METHODS. The highly vascularized chicken comb was selected as the animal model for hemangioma. The ND:YAG laser irradiation ranged from 2.6 to 35.1 1/mm². A feedback system utilizing infrared rediometry monitored the comb surface temperature and controlled delivery time to the cryogen spurt. When comb surface temperature during laser irradiation reached 36-42°C, a 30-100 msec cryogen spurt was delivered. Animals were euthanized 1 hour to 21 days following each experiment. Gross and histologic analyses were performed. RESULTS. Nd:YAG laser irradiation resulted in deep (up to 6.1 mm) tissue photocoagulation, which CSC preserved the overlying epidermis and papillary dermis. CONCLUSION. The results demonstrate that CSC is effective in protecting the epidermis and papillary dermis and papillary dermis, while achieving deep tissue photocoagulation during ND:YAG laser irradiation. Further pilot studies in humans appear warranted. [ABSTRACT FROM AUTHOR]