title: Intraoperative, real-time monitoring of blood flow dynamics associated with laser surgery of port wine stain birthmarks.
abstract: OBJECTIVE
  Port-wine stain (PWS) birthmarks affect ∼22 million people worldwide. After several treatment sessions, complete disappearance of the PWS occurs in only ∼10% of treated patients. There is a need to develop a new strategy to improve the efficacy of each treatment session and the overall treatment outcome. The study objective was to determine how intraoperative measurements of blood flow correlate with treatment response assessed several weeks post treatment.
  
  
  METHODS
  We employed Laser Speckle Imaging (LSI) to measure intraoperative blood-flow dynamics. We collected data from 24 subjects undergoing laser therapy for facial PWS birthmarks. Photographs were taken before treatment and at a follow-up visit, and analyzed by two expert observers.
  
  
  RESULTS
  Intraoperative LSI enables real-time monitoring of blood-flow dynamics in response to laser treatment and can inform clinicians on the need for focused re-treatment. The degree of PWS blanching achieved is positively correlated with the log-transformed acute blood-flow reduction (P = 0.022).
  
  
  CONCLUSIONS
  LSI is a simple, intraoperative monitoring tool during laser therapy of PWS birthmarks. LSI provides a single value for blood flow that correlates well with the degree of blanching achieved with laser therapy.
authors.affiliation: Beckman Laser Institute and Medical Clinic, University of California, Irvine, California 92612.|Department of Biomedical Engineering, University of California, Irvine, California 92697.
authors.forename: Bruce
authors.initials: B
authors.lastname: Yang
authors.affiliation: Beckman Laser Institute and Medical Clinic, University of California, Irvine, California 92612.|Department of Biomedical Engineering, University of California, Irvine, California 92697.
authors.forename: Owen
authors.initials: O
authors.lastname: Yang
authors.affiliation: Beckman Laser Institute and Medical Clinic, University of California, Irvine, California 92612.|Department of Biomedical Engineering, University of California, Irvine, California 92697.
authors.forename: John
authors.initials: J
authors.lastname: Guzman
authors.affiliation: Beckman Laser Institute and Medical Clinic, University of California, Irvine, California 92612.|Department of Biomedical Engineering, University of California, Irvine, California 92697.
authors.forename: Paul
authors.initials: P
authors.lastname: Nguyen
authors.forename: Christian
authors.initials: C
authors.lastname: Crouzet
authors.affiliation: Division of Hematology/Oncology, School of Medicine, University of California, Irvine, California 92697.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Osann
authors.affiliation: Beckman Laser Institute and Medical Clinic, University of California, Irvine, California 92612.|Department of Dermatology, University of California, Irvine, California 92697.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Kelly
authors.affiliation: Beckman Laser Institute and Medical Clinic, University of California, Irvine, California 92612.|Department of Biomedical Engineering, University of California, Irvine, California 92697.|Division of Hematology/Oncology, School of Medicine, University of California, Irvine, California 92697.|Department of Dermatology, University of California, Irvine, California 92697.|Department of Surgery, University of California, Irvine, California 92697.
authors.forename: J Stuart
authors.initials: JS
authors.lastname: Nelson
authors.affiliation: Beckman Laser Institute and Medical Clinic, University of California, Irvine, California 92612.|Department of Biomedical Engineering, University of California, Irvine, California 92697.|Department of Surgery, University of California, Irvine, California 92697.|Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine, California 92697.
authors.forename: Bernard
authors.initials: B
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005145:Face; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D054025:Lasers, Dye / Q000627:therapeutic use*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D061848:Optical Imaging / Q000379:methods*; D019339:Port-Wine Stain / Q000601:surgery*; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply*; D016896:Treatment Outcome; D055815:Young Adult
keywords: blood perfusion; laser Doppler; optical imaging; pulsed dye laser; speckle contrast