title: Combined photodynamic and photothermal induced injury enhances damage to in vivo model blood vessels.
abstract: OBJECTIVE
  The degree of port wine stain (PWS) blanching following pulsed dye laser (PDL) therapy remains variable and unpredictable. Because of the limitations of current PDL therapy, alternative treatment approaches should be explored. The objective was to evaluate a novel methodology for selective vascular damage, combined photodynamic (PDT) and photothermal (PDL) treatment, using the in vivo chick chorioallantoic membrane (CAM) model.
  
  
  METHODS
  Thirty microliters of benzoporphyrin derivative monoacid ring A (BPD) solution was administered intraperitoneally into chick embryos at day 12 of development. Study groups were: (1) control (no BPD, no light); (2) BPD alone; (3) continuous wave irradiation (CW) alone (576 nm, 60 mW/cm2, 125 seconds); (4) CW + PDL; (5) BPD+PDL; (6) PDT (BPD+CW); (7) PDL alone (585 nm, 4 J/cm(2)); and (8) PDT+PDL (BPD + CW followed immediately by PDL). Vessels were videotaped prior to, and at 1 hour post-intervention and then assessed for damage based on the following scale: 0, no damage; 1, coagulation; 1.5, vasoconstriction; 2.0, coagulation+vasoconstriction; 2.5, angiostasis; 3.0, hemorrhage. Damage scores were weighted by vessel "order."
  
  
  RESULTS
  PDT + PDL resulted in significantly (P < 0.01) more severe vascular damage than was observed in any other study group: 127% more than PDT, 47% more than PDL alone.
  
  
  CONCLUSIONS
  PDT + PDL is a novel and promising approach for selective vascular damage and may offer a more effective method for treatment of PWS and other vascular skin lesions.
authors.affiliation: Beckman Laser Institute, University of California, Irvine, California 92612, USA. KMKelly@uci.edu
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Kelly
authors.forename: Sol
authors.initials: S
authors.lastname: Kimel
authors.forename: Tia
authors.initials: T
authors.lastname: Smith
authors.forename: Amy
authors.initials: A
authors.lastname: Stacy
authors.forename: Marie J
authors.initials: MJ
authors.lastname: Hammer-Wilson
authors.forename: Lars O
authors.initials: LO
authors.lastname: Svaasand
authors.forename: J Stuart
authors.initials: JS
authors.lastname: Nelson
mesh_terms: D000481:Allantoin; D000818:Animals; D002642:Chick Embryo; D002823:Chorion / Q000098:blood supply; D003131:Combined Modality Therapy; D028022:Low-Level Light Therapy / Q000009:adverse effects*; D008833:Microcirculation / Q000187:drug effects / Q000293:injuries / Q000473:pathology* / Q000528:radiation effects; D018715:Microscopy, Video; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000494:pharmacology; D011166:Porphyrins / Q000494:pharmacology; D000077362:Verteporfin
chemical_list: D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D000481:Allantoin