Cutera Excel V - Selecting Vascular Treatment Parameters; Vascular Parameter Selection Guide

D1091 Rev.M August. 2016
8
SELECTING TREATMENT PARAMETERS FOR VASCULAR TREATMENTS
Select parameters in the order listed below. Always start with the least aggressive settings for a specific vessel.
Observe laser-tissue interaction and clinical response to determine appropriate settings for each patient.
1. Wavelength is measured in nanometers (nm). Selection is based on vessel depth and color.
• superficial vessel (fine to moderate size, pink to red) = 532 nm
• larger, deeper vessel (very dark red, blue to purple) = 1064 nm
2. Spot Size is measured in millimeters (mm). Selection is based on treatment type and vessel depth.
• linear vessels, superficial = smaller spot size
• linear vessels, deeper = larger spot size
• area treatments/diffuse redness = larger spot size
• larger spot sizes penetrate deeper with the 1064 nm wavelength and are typically more uncomfortable.
3. Fluence is the energy, measured in J/cm
2
. Selection is based on vessel size, depth, and skin type.
• 532 nm: smaller vessels = lower fluence; larger vessels = higher fluence
• 1064 nm: smaller vessels = higher fluence; larger vessels = lower fluence
• darker skin types or tan skin = lower fluence
4. Pulse Duration is the length of each pulse, measured in milliseconds (ms). Selection is based on vessel size
and
color.
• smaller diameter, lighter vessel = shorter pulse duration
• larger diameter, darker vessel = longer pulse duration
• darker skin types or tan skin = longer pulse duration
• Pulse durations shorter than 10 ms increase the likelihood of purpura when treating vascular lesions.
5. Window Temperature is measured in
o
Celsius. Four options are available: 5
o
, 10
o
, 15
o
, and 20
o
C.
• 5
o
or 10
o
C is recommended for vascular indications for increased epidermal protection and patient comfort.
• 5
o
C is recommended for larger, darker vessels and vascular birthmarks (more hemoglobin).
• Use the lowest window temperature in which the desired clinical endpoint can be achieved.
6. Repetition Rate is the number of pulses per second, measured in Hz, with foot pedal depressed.
• For increased epidermal safety, use single pulses (0.0 Hz) with pre and post cooling.
• Low to Moderate Repetition Rate is recommended for the large area Global Treatment.
7. Contact Cooling – Sapphire window provides pre, parallel, and post cooling.
• Pre-cooling protects the epidermis by reducing initial skin temperature.
• Parallel cooling during the laser pulse protects the epidermis while the laser is firing.
• Post-cooling extracts heat from tissue to help prevent epidermal injury.
• Longer pre and post cooling is recommended when treating larger, darker vessels, darker skin types and tan
skin.
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Spot Size
Linear vessels
Superficial vessels
Area treatments
Deeper vessels
Fluence
532 nm: Smaller vessels
1064 nm: Larger vessels
532 nm: Larger vessels
1064 nm: Smaller vessels
Pulse Duration
Smaller vessels
Larger vessels
Darker skin types
Tan skin
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