WO1997045163A1 - Reduction of vascular blemishes by selective thermolysis - Google Patents

Reduction of vascular blemishes by selective thermolysis Download PDF

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Publication number
WO1997045163A1
WO1997045163A1 PCT/GB1997/001411 GB9701411W WO9745163A1 WO 1997045163 A1 WO1997045163 A1 WO 1997045163A1 GB 9701411 W GB9701411 W GB 9701411W WO 9745163 A1 WO9745163 A1 WO 9745163A1
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WO
WIPO (PCT)
Prior art keywords
beams
radiation
laser radiation
laser
vascular
Prior art date
Application number
PCT/GB1997/001411
Other languages
French (fr)
Inventor
Robert Marc Clement
Michael Kiernan
Original Assignee
Sls Biophile Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Sls Biophile Limited filed Critical Sls Biophile Limited
Priority to US09/194,528 priority Critical patent/US6605083B2/en
Priority to AU29100/97A priority patent/AU2910097A/en
Publication of WO1997045163A1 publication Critical patent/WO1997045163A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/203—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser applying laser energy to the outside of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00747—Dermatology
    • A61B2017/00756—Port wine stains
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00452—Skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00452—Skin
    • A61B2018/00458—Deeper parts of the skin, e.g. treatment of vascular disorders or port wine stains

Definitions

  • the present invention relates to a method and apparatus for cosmetic reduction of vascular skin blemishes by means of thermolysis using laser irradiation
  • Vascular irregularities below the surface of the skin can cause visible skin blemishes such as the conditions commonly referred to as Portwine stains, Naevus, Telangiectasia, Strawberry Haemangioma and Thread veins. It has become common practice to cosmetically reduce and preferably remove such vascular blemishes using techniques known as selective thermolysis in which pulsed laser light of a pre-selected wavelength incident on and passing through the skin of a patient is specifically absorbed by a target vascular irregularity lesion leading to "coagulation necrosis" which results in a cosmetic normalising of the colour or tint of the visible blemish with the surrounding skin.
  • selective thermolysis in which pulsed laser light of a pre-selected wavelength incident on and passing through the skin of a patient is specifically absorbed by a target vascular irregularity lesion leading to "coagulation necrosis" which results in a cosmetic normalising of the colour or tint of the visible blemish with the surrounding skin.
  • a flash lamp pumped dye laser has been utilised emitting light at a wavelength of between 570nm - 600nm at typical output energy levels of 5 - 15 J/cm 2 with pulse durations in the range 100 - 600 micro-seconds.
  • thermolysis In known selective thermolysis techniques, only a relatively small proportion of the volume of individual blood vessels (depending on the size of the vessels, which can be from 5 microns to 2mm) comprising the vascular irregularity lesion is heated to thermolysis temperature during the laser pulse. The thermolysis effect is therefore limited to a localised volume of the blood vessels and reduces the probability of the blemish being removed by the treatment.
  • the invention seeks to alleviate the above- mentioned difficulty.
  • the invention provides a method of cosmetically reducing a vascular blemish at or below the surface of mammalian skin, which method comprises directing laser radiation to converge toward said blemish from a plurality of different directions, thereby to cause selective thermolysis of blood vessels comprising said vascular blemish.
  • the directed laser radiation is arranged to converge below the surface of the skin. Irradiating the vascular blemish from a plurality of different directions rather than from a single direction only (usually normal to the skin) as with conventional thermolysis techniques, causes a larger volume of individual vessels comprising the vascular blemish to be heated, thereby increasing the average vessel temperature and hence increasing the likelihood of complete or substantial removal of the blemish.
  • a plurality of substantially linear paths of radiation are provided, each preferably comprising a separate beam, being arrange to converge toward the vascular blemish.
  • the respective paths or beams are angularly spaced relatively to one another.
  • one of the beams or paths is directed normally to the skin of the patient at least one further beam or path being directed at an inclined angle relative to the skin of the patient.
  • the laser radiation is directed to converge from the plurality of different directions effectively simultaneously.
  • the directed radiation is pulsed preferably having a pulse duration in the range 100 to 600 micro ⁇ seconds.
  • the laser radiation may comprise a primary beam which is split into a plurality of individual beams which are subsequently directed to converge on the vascular blemish.
  • separate beams may be used, each from a separate source. It is preferred that the laser radiation converging from the plurality of directions is of the same wavelength (and preferably the same intensity) from each direction. Each of the converging laser beams are therefore effectively identical.
  • laser apparatus for use in selective thermolysis techniques, the apparatus comprising means for directing a laser radiation to converge from a plurality of different directions at a zone of convergence spaced from the apparatus.
  • the apparatus is arranged to produce a plurality of beams each directed along a respective substantially linear path, the beams being angularly spaced from one another to converge at the zone of convergence.
  • the beams are arranged to be of substantially the same wavelength, and also preferably of substantially the same intensity.
  • apparatus may comprise division means for dividing the plurality of laser beams from a primary beam.
  • the division means preferably comprises optical means which may include mirrors and/or beam splitters and/or optical prisms.
  • focusing means is provided to focus each beam at the convergence zone.
  • the focusing means comprises a focusing lens.
  • modification means is provided to modify the configuration of the beams for example by providing that the focusing means is arranged to focus the respective beam to a line rather than a point or spot.
  • An at least partially cylindrical optic lens is preferably provided for this purpose.
  • laser apparatus for use in selective thermolysis techniques and comprising focusing means arranged to focus a laser beam to a line is inventive per se. This is particularly useful where the target blemish for photothermolysis is substantially linear such as, for example, a thread vein.
  • the apparatus may comprise discrete laser sources arranged to produce each respective laser beam.
  • pulsation means is provided to pulse the laser radiation.
  • Figure 1 is a schematic representation of a prior art photothermolysis technique
  • Figure 2 is a schematic representation of the method according to the invention.
  • FIG. 3 is a schematic representation of an embodiment of apparatus according to the invention.
  • Figure 4 is a schematic representation of a component suitable for use in an embodiment of the apparatus of Figure 3.
  • thermolysis techniques utilise a uni-directional beam 1 of laser radiation aimed in a direction substantially normal to the surface of the skin 2 and impinging on a sub-cutaneous blood vessel 3 comprising a general region 4 of vascular irregularity such as a Portwine stain, Strawberry Haemangioma or the like.
  • the laser radiation incident on vessel 3 heats a relatively small peripheral volume 5 of the vessel to the thermolysis temperature which leaves a substantial volume of the vessel insufficiently heated and therefore the vascular blemish is not entirely removed.
  • the technique according to the invention utilises three discrete beams 7, 8, 9 of laser radiation passing through the surface of the skin 2 at different inclinations and arranged to converge on vessels 3 in the region 4 of the vascular irregularity.
  • This has the benefit of ensuring that a larger peripheral volume 5a of the vessel 3 is heated to thermolysis temperature and thereby ensures more complete removal of the vascular blemish.
  • the beams 7, 8, 9 of radiation are superposed only in the region 4 of the vascular irregularity, the high intensity needed for thermolysis is restricted to that region because each individual beam may be of lower intensity radiation. This prevents over heating and thermal damage being caused to tissue outside region 4.
  • FIG. 3 shows apparatus suitable for use in reducing a vascular blemish in accordance with the invention.
  • the apparatus comprises a laser source 10, beam splitters 11, 12 (each arranged to transmit 66% and reflect 33% of incoming radiation) and mirror reflectors 13, 14 arranged to divide the primary beam 14 into three beams 15, 16, 17 which are focused by lenses 18 to converge below the surface of the skin 2.
  • the beams 15, 16, 17 may be modified by means of a cylinder optic lens 18a (shown in Figure 6) to produce a line of focus 19 rather than a point or spot as with conventional optics. This is particularly useful for use in removing elongate blemishes such as thread veins.

Abstract

Vascular blemishes are reduced by directing pulsed laser radiation to converge toward the blemishes in a plurality of directions, each beam of radiation being derived from a primary radiation source or from a separate radiation source, thereby to cause selective thermolysis of blood vessels in the blemishes.

Description

Reduction of Vascular Blemishes by Selective Thermolysis
The present invention relates to a method and apparatus for cosmetic reduction of vascular skin blemishes by means of thermolysis using laser irradiation
Vascular irregularities below the surface of the skin can cause visible skin blemishes such as the conditions commonly referred to as Portwine stains, Naevus, Telangiectasia, Strawberry Haemangioma and Thread veins. It has become common practice to cosmetically reduce and preferably remove such vascular blemishes using techniques known as selective thermolysis in which pulsed laser light of a pre-selected wavelength incident on and passing through the skin of a patient is specifically absorbed by a target vascular irregularity lesion leading to "coagulation necrosis" which results in a cosmetic normalising of the colour or tint of the visible blemish with the surrounding skin. Typically a flash lamp pumped dye laser has been utilised emitting light at a wavelength of between 570nm - 600nm at typical output energy levels of 5 - 15 J/cm2 with pulse durations in the range 100 - 600 micro-seconds.
In known selective thermolysis techniques, only a relatively small proportion of the volume of individual blood vessels (depending on the size of the vessels, which can be from 5 microns to 2mm) comprising the vascular irregularity lesion is heated to thermolysis temperature during the laser pulse. The thermolysis effect is therefore limited to a localised volume of the blood vessels and reduces the probability of the blemish being removed by the treatment.
The present invention seeks to alleviate the above- mentioned difficulty. According to a first aspect, the invention provides a method of cosmetically reducing a vascular blemish at or below the surface of mammalian skin, which method comprises directing laser radiation to converge toward said blemish from a plurality of different directions, thereby to cause selective thermolysis of blood vessels comprising said vascular blemish.
Because the vessels comprising the blemish are below the surface of the skin, the directed laser radiation is arranged to converge below the surface of the skin. Irradiating the vascular blemish from a plurality of different directions rather than from a single direction only (usually normal to the skin) as with conventional thermolysis techniques, causes a larger volume of individual vessels comprising the vascular blemish to be heated, thereby increasing the average vessel temperature and hence increasing the likelihood of complete or substantial removal of the blemish.
It is preferred that a plurality of substantially linear paths of radiation are provided, each preferably comprising a separate beam, being arrange to converge toward the vascular blemish. Preferably the respective paths or beams are angularly spaced relatively to one another. Desirably, one of the beams or paths is directed normally to the skin of the patient at least one further beam or path being directed at an inclined angle relative to the skin of the patient.
Advantageously, the laser radiation is directed to converge from the plurality of different directions effectively simultaneously. Desirably the directed radiation is pulsed preferably having a pulse duration in the range 100 to 600 micro¬ seconds.
In a first embodiment of method according to the invention, the laser radiation may comprise a primary beam which is split into a plurality of individual beams which are subsequently directed to converge on the vascular blemish. Alternatively, separate beams may be used, each from a separate source. It is preferred that the laser radiation converging from the plurality of directions is of the same wavelength (and preferably the same intensity) from each direction. Each of the converging laser beams are therefore effectively identical.
According to a second aspect of the invention, there is provided laser apparatus for use in selective thermolysis techniques, the apparatus comprising means for directing a laser radiation to converge from a plurality of different directions at a zone of convergence spaced from the apparatus.
It is preferred that the apparatus is arranged to produce a plurality of beams each directed along a respective substantially linear path, the beams being angularly spaced from one another to converge at the zone of convergence.
Advantageously, the beams are arranged to be of substantially the same wavelength, and also preferably of substantially the same intensity.
In one embodiment, apparatus according to the invention may comprise division means for dividing the plurality of laser beams from a primary beam. The division means preferably comprises optical means which may include mirrors and/or beam splitters and/or optical prisms. Desirably, focusing means is provided to focus each beam at the convergence zone. Typically the focusing means comprises a focusing lens.
It is preferred that in certain embodiments modification means is provided to modify the configuration of the beams for example by providing that the focusing means is arranged to focus the respective beam to a line rather than a point or spot. An at least partially cylindrical optic lens .is preferably provided for this purpose.
It is believed that laser apparatus for use in selective thermolysis techniques and comprising focusing means arranged to focus a laser beam to a line is inventive per se. This is particularly useful where the target blemish for photothermolysis is substantially linear such as, for example, a thread vein. In an alternative embodiment, the apparatus may comprise discrete laser sources arranged to produce each respective laser beam.
In either embodiment, it is preferred that pulsation means is provided to pulse the laser radiation.
Specific embodiments of the invention will now be further described by way of example only, and with reference to the accompanying drawings, in which:
Figure 1 is a schematic representation of a prior art photothermolysis technique;
Figure 2 is a schematic representation of the method according to the invention;
Figure 3 is a schematic representation of an embodiment of apparatus according to the invention, and
Figure 4 is a schematic representation of a component suitable for use in an embodiment of the apparatus of Figure 3.
Referring to Figure 1, prior art thermolysis techniques utilise a uni-directional beam 1 of laser radiation aimed in a direction substantially normal to the surface of the skin 2 and impinging on a sub-cutaneous blood vessel 3 comprising a general region 4 of vascular irregularity such as a Portwine stain, Strawberry Haemangioma or the like. The laser radiation incident on vessel 3 heats a relatively small peripheral volume 5 of the vessel to the thermolysis temperature which leaves a substantial volume of the vessel insufficiently heated and therefore the vascular blemish is not entirely removed.
Referring to Figure 2, the technique according to the invention utilises three discrete beams 7, 8, 9 of laser radiation passing through the surface of the skin 2 at different inclinations and arranged to converge on vessels 3 in the region 4 of the vascular irregularity. This has the benefit of ensuring that a larger peripheral volume 5a of the vessel 3 is heated to thermolysis temperature and thereby ensures more complete removal of the vascular blemish. Furthermore, because the beams 7, 8, 9 of radiation are superposed only in the region 4 of the vascular irregularity, the high intensity needed for thermolysis is restricted to that region because each individual beam may be of lower intensity radiation. This prevents over heating and thermal damage being caused to tissue outside region 4. As a corollary, it is possible to have a higher intensity of radiation in the region 4 than is the case with conventional single beam thermolysis techniques due to the effect of superposition.
Figure 3 shows apparatus suitable for use in reducing a vascular blemish in accordance with the invention. The apparatus comprises a laser source 10, beam splitters 11, 12 (each arranged to transmit 66% and reflect 33% of incoming radiation) and mirror reflectors 13, 14 arranged to divide the primary beam 14 into three beams 15, 16, 17 which are focused by lenses 18 to converge below the surface of the skin 2.
In an embodiment of the apparatus, the beams 15, 16, 17 may be modified by means of a cylinder optic lens 18a (shown in Figure 6) to produce a line of focus 19 rather than a point or spot as with conventional optics. This is particularly useful for use in removing elongate blemishes such as thread veins.

Claims

Claims t
1. Apparatus for use in selective thermolysis for cosmetically reducing a vascular blemish at or below the surface of mammalian skin, the apparatus comprising means for directing laser radiation to converge from a plurality of directions at a zone of convergence spaced from the apparatus.
2. Apparatus according to claim 1, which includes means arranged to produce a plurality of discrete laser beams each directed along a respective substantially linear beam path, each beam path being angularly spaced from each other beam path such that said beam paths converge at said zone of convergence.
3. Apparatus according to claim 2, wherein a first one of the beams is arranged to be directed substantially normally to the skin, a further beam being inclined at an angle to the first beam.
4. Apparatus according to claim 2 or claim 3, wherein the apparatus is arranged to produce three discrete beams.
5. Apparatus according to any preceding claim, wherein discrete beams of laser radiation are arranged to be superposed at the zone of convergence producing a region of relatively higher intensity compared to the relatively lower intensity radiation comprising the respective discrete beams.
6. Apparatus according to any of claims 2 to 5, further comprising division means for dividing said plurality of beams from a primary beam.
7. Apparatus according to claim 6, wherein said division means comprises optical means.
8. Apparatus according to any of claims 2 to 5, wherein a plurality of laser beam sources are provided, each arranged to produce a respective laser beam.
9. Apparatus according to any preceding claim, further comprising focusing means arranged to focus each of said beams at said convergence zone.
10. Apparatus according to any preceding claim, further comprising modification means arranged to modify the configuration of said beams.
11. Apparatus according to claim 10, wherein the modification means comprises optical means arranged to modify the cross sectional shape of the beam.
12. Apparatus according to claim 111, wherein the modification means comprises optical means arranged to focus the beam to a line.
13. Apparatus according to any preceding claim, which includes pulsation means arranged to pulse said laser radiation.
14. Apparatus according to any preceding claim, wherein means is provided for producing a plurality of beams of substantially the same wavelength and substantially the same intensity.
15. A method of cosmetically reducing a vascular blemish at or below the surface of mammalian skin, which method comprises directing laser radiation to converge toward said blemish from a plurality of directions, thereby to cause selective thermolysis of blood vessels comprising said vascular blemish.
16. A method according to claim 15, wherein said laser radiation comprises a plurality of substantially linear paths of radiation, each comprising a separate beam, arranged to converge toward said vascular blemish.
17. A method according to claim 16, wherein said separate beams derive from a primary beam.
18. A method according to claim 16, wherein said separate beams are each from a separate source.
19. A method according to any of claims 16 to 18, wherein said respective paths are angularly spaced relative to one another.
20. A method according to any of claims 15 to 19, wherein said laser radiation is pulsed.
21. A method according to claim 20, wherein said pulsed radiation has pulses of duration in the range 100 to 600 microseconds.
22. A method according to any of claims 15 to 21, wherein said converging laser radiation comprises beams of substantially the same wavelength and substantially the same intensity.
23. A method according to any of claims 15 to 22, wherein said converging laser radiation comprises a plurality of beams arranged to converge and be superposed at the zone of convergence producing a region of relatively higher intensity compared to the relatively lower intensity radiation of the discrete beams.
PCT/GB1997/001411 1996-05-29 1997-05-23 Reduction of vascular blemishes by selective thermolysis WO1997045163A1 (en)

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Application Number Priority Date Filing Date Title
US09/194,528 US6605083B2 (en) 1996-05-29 1997-05-23 Reduction of vascular blemishes by selective thermolysis
AU29100/97A AU2910097A (en) 1996-05-29 1997-05-23 Reduction of vascular blemishes by selective thermolysis

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GB9611170.3 1996-05-29
GBGB9611170.3A GB9611170D0 (en) 1996-05-29 1996-05-29 Reduction of vascular blemishes by selective thermolysis

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AU (1) AU2910097A (en)
GB (1) GB9611170D0 (en)
WO (1) WO1997045163A1 (en)
ZA (1) ZA974729B (en)

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WO1998043704A1 (en) * 1997-04-02 1998-10-08 Wound Healing Of Oklahoma, Inc. Laser light delivery system and method
US6099554A (en) * 1997-04-02 2000-08-08 Wound Healing Of Oklahoma Laser light delivery method

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US20020013578A1 (en) 2002-01-31
US6605083B2 (en) 2003-08-12
GB9611170D0 (en) 1996-07-31
ZA974729B (en) 1998-08-25

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