Proliferative Vascular Disease

VivoSight measures depth, diameter and density of vessels in vascular lesions

Kelly and Waibel et. al. [1] used VivoSight and showed that vascular lesions have a broad range of vessel diameters and depths.

Successful therapy is based on the principles of Selective Photothermolysis (Anderson and Parrish, Science 1983) which requires:

  • Wavelength that is preferentially absorbed by the desired target structure
  • Laser pulse width that is less than or equal to the thermal relaxation time of the vessel targeted as determined by Vessel Diameter
  • Sufficient radiant exposure, Fluence, to reach a damaging temperature in the target. Vessel Depth can impact fluence requirements.
The wide variety of challenging vascular lesions requires better data on the underlying vascular pathology for better treatment

VivoSight vascular measurements inform treatment parameters for therapy that is targeted to lesion characteristics.

Vascular measurements are extracted from OCT image data processing

Clinical Application Areas:

Port Wine Stains, Hemangiomas and Rosacea show a wide variety of vascular metrics, requiring a more individual treatment approach:

Rosacea: • Plexus depth: 265 μm • Vessel diameter: 119 μm • Vessel density: 34 %
Port Wine Stain: • Plexus depth: 168 μm • Vessel diameter: 234 μm • Vessel density: 46 %

References:

1. Waibel JS, Holmes J, Rudnick A, Woods D, Kelly KM. Angiographic optical coherence tomography imaging of hemangiomas and port wine birthmarks. Lasers Surg Med. 2018 Mar 22

2. Christman MP, Feng H, Holmes J, Geronemus RG. Treating port wine stain birthmarks using dynamic optical coherence tomography-guided settings. J Am Acad Dermatol. 2019 Aug 19.

3. Ulrich M, Themstrup L, de Carvalho N, Manfredi M, Grana C, Ciardo S, Kästle R, Holmes J, Whitehead R, Jemec G, Pellacani G, Welzel J. Dynamic Optical Coherence Tomography in Dermatology. Dermatology DOI: 10.1159/000444706

4. Schuh S, Holmes J, Ulrich M, Themstrup L, Jemec GBE, Pellacani G, Welzel J. Imaging blood vessel morphology in skin: dynamic optical coherence tomography as a novel potential diagnostic tool in dermatology. Dermatol Ther (Heidelb). 2017;7(2):187–202

5. Themstrup L, Ciardo S, Manfredi M, Ulrich M, Pellacani G, Welzel J, Jemec GBE. In vivo, micro-morphological vascular changes induced by topical brimonidine studied by Dynamic optical coherence tomography. J Eur Acad Dermatol Venereol. 2016 Jun;30(6):974-9

6. Themstrup, L., et al., Validation of Dynamic optical coherence tomography for non-invasive, in vivo microcirculation imaging of the skin, Microvasc. Res. (2016), Shttp://dx.doi.org/10.1016/j.mvr.2016.05.004

7. Byers RA, Fisher M, Bown NJ, Tozer GM, Matcher SJ. Vascular patterning of subcutaneous mouse fibro sarcomas expressing individual VEGF isoforms can be differentiated using angiographic optical coherence tomography. Biomedical Optics Express (BOE) Vol. 8, No. 10 | 1 Oct 2017.

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