{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:20:05Z","timestamp":1759969205623,"version":"build-2065373602"},"reference-count":44,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The standard Port Wine Stains (PWS) treatment involves using single pulse high fluence (SPHF) laser therapy, which often leads to discomfort and requires multiple sessions. According to the Arrhenius theory, employing multiple pulses with low fluence (MPLF) that have lower peak power could potentially reduce pain while still achieving the therapeutic goals. This study aims to explore the potential of MPLF at 530\u2009nm in achieving the desired clinical endpoints in treating PWS. Additionally, it seeks to validate the predictions of the Arrhenius theory regarding thermal denaturation against empirical data, utilizing established kinetic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We evaluated vascular responses to SPHF and MPLF approaches using the chorioallantoic membrane (CAM) model and a 530\u2009nm customized fiber laser. Vascular changes were observed with a digital microscope, and temperature was monitored with a thermal camera during irradiation through a 3\u2009\u00d7\u20093\u2009mm spot at 9\u201310\u2009ms pulse durations, targeting stable coagulum and vessel collapse. First, we established the SPHF threshold, then applied MPLF at 20%\u201375% of this fluence with a pulse duration of 9\u201310\u2009ms and a repetition rate of 0.1 or 0.2\u2009Hz (corresponding to 1 pulse every 10 or 5\u2009s, respectively). Additionally, we used the Arrhenius theory with specific kinetic parameters to predict and validate thermal damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed that both SPHF and MPLF approaches effectively achieved clinical endpoints. Stable coagulum formation was successful at a fluence of 4.2\u2009J\/cm\u00b2 with a pulse width of 10\u2009ms under SPHF. Similarly, MPLF achieved stable coagulum at a lower fluence of 2.2\u2009J\/cm\u00b2, with the thrombus forming after 16 pulses and enlarging by the 32nd pulse. Vessel collapse was also noted at a fluence of 10.8\u2009J\/cm\u00b2 in the SPHF regime and at 5.9\u2009J\/cm\u00b2 with MPLF, with early closure observed after the fourth pulse and completion by the sixteenth. Surface temperature measurements indicated a minor rise following laser exposure, which quickly returned to near baseline levels. Using two sets of activation energies, the Arrhenius model predicted the extent of vessel denaturation and informed the number of pulses required to reach the damage threshold, indicating a lower slope and thus easier damage accumulation with MPLF below the SPHF threshold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides evidence that using MPLF laser treatment at 530\u2009nm with fluences ranging from 50% to 70% of the SPHF threshold can effectively induce stable coagulum and vessel collapse within the CAM model while maintaining baseline temperatures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.70045","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T03:05:44Z","timestamp":1758596744000},"page":"726-734","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immediate Tissue Responses to Multipulse Low Fluence Laser Treatment in a Chorioallantoic Membrane Model of Port Wine Birthmarks"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6825-6705","authenticated-orcid":false,"given":"Cemre Busra","family":"Turk","sequence":"first","affiliation":[{"name":"Wellman Center for Photomedicine Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Department of Dermatology Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Childs","sequence":"additional","affiliation":[{"name":"IPG Photonics, Inc. Marlborough Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilya","family":"Yaroslavsky","sequence":"additional","affiliation":[{"name":"IPG Photonics, Inc. Marlborough Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Altshuler","sequence":"additional","affiliation":[{"name":"IPG Photonics, Inc. Marlborough Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4966-3035","authenticated-orcid":false,"given":"R.","family":"Rox Anderson","sequence":"additional","affiliation":[{"name":"Wellman Center for Photomedicine Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Department of Dermatology Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8998-0030","authenticated-orcid":false,"given":"Yakir S.","family":"Levin","sequence":"additional","affiliation":[{"name":"Wellman Center for Photomedicine Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Department of Dermatology Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.7.5.287"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12535052"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2004.30259.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.22000"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.1983.tb01093.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2021.08.006"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.58.2.218"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20788"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-020-03007-0"},{"key":"e_1_2_10_11_1","first-page":"27","article-title":"Laser Treatment of Port\u2010Wine Stains","volume":"8","author":"Brightman L. 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