Alexandrite and Diode Lasers

Abstract

While the current gold standard for the laser treatment of vascular lesions is the pulsed dye laser (577-595 nm), laser systems with longer wavelengths have been employed in an effort to maintain vascular selectivity and achieve greater depths of penetration while minimizing adverse effects. This chapter will discuss the safety and efficacy of the 755-nm alexandrite laser, the 810-nm and 940-nm diode lasers, and the 1,470-nm diode laser used in endovenous laser ablation for the treatment of vascular lesions.The primary target for the treatment of vascular lesions is the chromophore hemoglobin. Based on the theory of selective photothermolysis, chromophore-specific wavelengths can induce selective thermal damage while sparing surrounding healthy tissue and epidermis. In the case of vascular lesions, the ideal wavelength coincides with 1 of 3 hemoglobin absorption peaks: 418, 542, or 577-595 nm. While the 418-nm peak is the most specific for hemoglobin, light emitted at this wavelength also strongly targets the melanosome, resulting in treatment-related pigmentary alteration and possible epidermal injury.The current gold standard for the laser treatment of vascular lesions is the pulsed dye laser (PDL; 577-595 nm); however, in an effort to maintain vascular selectivity and achieve greater depths of penetration while minimizing adverse effects, laser systems with longer wavelengths have been employed. This chapter will discuss the safety and efficacy of the 755-nm alexandrite laser, the 810-and 940-nm diode lasers, and the 1,470-nm diode laser used in endovenous laser ablation (EVLA) for the treatment of vascular lesions.