Computed temperature distributions around ectatic capillaries exposed to yellow (578 nm) laser light

We have numerically modelled the thermal effects of yellow (577 or 578 nm) light illumination on the ectatic blood vessels of port wine stains. We investigated the effect of the laser treatment parameters of light irradiance and illumination time on the extent of coagulation (coagulation thickness) of the endothelial cells of the ectatic vessels. We assumed that this coagulation is dependent on heating the cells to a critical temperature (coagulation temperature). We iteratively adjusted the treatment parameters so that the model vessels had a maximum temperature that did not exceed the boiling point of blood. Given the likely range of variation of coagulation temperature, coagulation thickness and vessel size, coagulation temperature was found to have the greatest effect on the treatment parameters. Variations in coagulation thickness had less influence, and the diameter of the ectatic vessel (typically in the 30-80 microns diameter range) had the least effect. The treatment parameters that have been shown clinically to cause purpura (e.g. 6-7 cm-2 in 360 microseconds) were also studied. The purpura seen by some workers using pulsed dye lasers is most likely to be the result of vaporisation of blood leading to the rupture of the vessel. We conclude that, in order to achieve coagulation with these short laser pulses, the choice of irradiance is critical.