The efficacy of the dual wavelength Gemini laser on resistant port wine stains: a pilot study

Abstract

Port wine stains (PWS) are vascular malformations resulting in ectatic blood vessels within the dermis. Laser treatment of port wine stains is based on selective photothermolysis of oxyhaemoglobin. Treatment is aimed at creating improvement of the port wine stain rather than complete eradication. A variety of different lasers are in use, all with their own limitations. The dual wavelength Gemini laser consists of a Nd:YAG 1,064-nm and a frequency-doubled KTP 532-nm laser. The Gemini offers the advantage of a larger spot size (10 mm), while maintaining the ability to deliver higher fluences. The large (10 mm) diameter spot size also allows an enhanced depth of penetration, enabling treatment of deeper vessels. To establish the efficacy of the Gemini laser on resistant port wine stains, we conducted a prospective study on five resistant port wine stains using the KTP component at 532 nm using 5- and 10-mm spot sizes. Improvement was seen in all patients. Areas treated with 10-mm spot size showed better improvement of the PWS compared to 5 mm spot size areas. In the case of treatment to a patient’s arm, response in the upper level of the limb was better than in the lower level. No adverse side effects were reported and discomfort was minimal. This pilot study demonstrates increased efficacy of the Gemini laser in the treatment of resistant port wine stains.