Excel V

AP0732 Rev A (07/14)

excel VTM

The New Gold

Standard for

Vascular & Benign

Pigmented Lesions

AP0732 Rev A (07/14)

Overview

I. Introduction

II. excel V™ Advanced Dual Wavelength Laser

III. excel V 532 nm

IV. excel V 1064 nm

V. Genesis V™ 1064 nm Micro-Pulsed Laser

AP0732 Rev A (07/14)

excel V At a Glance

CUTERA’s excel V is the most advanced

precision laser to treat ALL vascular and many

benign pigmented conditions

ROIExtensive Tx

capabilities, no consumables

VersatilityEffectively treats

all vascular and

most BPLs, All

skin types

TechnologyHigh-Powered

Dual

wavelength (532

nm/1064 nm)

EfficiencyLarge spot, short

pulse width at

therapeutic

fluences

AP0732 Rev A (07/14)

Versatility and efficacy for all vascular lesions

and benign pigmented lesions

AP0732 Rev A (07/14)

Indications

• Telangiectasia

• Leg Veins

• Spider Angiomas

• Cherry Angiomas

• Neovascularization

• Venous Lakes

Vascular Lesions

• Port Wine Stains

• Rosacea/ Matting

• Diffused Redness

Benign Pigmented Lesions

• Lentigines

• DPN’s

• Poikiloderma of Civatte

• Freckles

• Café-au-lait Stains

• Melasma

Cutaneous Lesions

• Verruca

• Skin Tags• Keratoses

Other

• Red Scars

AP0732 Rev A (07/14)

Advanced Design

Compact Design• Small footprint• 30 seconds start up• Runs quiet and cool

No Disposables/Consumables• Sapphire cooling• Solid-state design• Plugs into 110v or 220v

Intuitive User Interface• Recommends settings for novice

or allows direct selection for advanced users

Real Time Calibration • System continually monitors laser

output to ensure each laser pulse is exactly the same – no waiting for calibration. The First High-energy

Flashlamp Pumped

532nm and 1064nm

Solid State LaserKilowatt Peak Power Levels

Capable of purpura

Up to 10 Hz

AP0732 Rev A (07/14)

Intelligent Delivery

Excellent Visibility• Unique cut-out design• Large diameter sapphire window • Visibility throughout treatment

Adjustable Spot Size• On-the-fly adjustments, system

stays in Ready Mode, saves time• 2mm to 12mm • Real-time calibration

Parallel Cooling• Variable temperature sapphire

window• Superior cooling before, during,

and after each pulse • Selectable 5°C to 20 °C

AP0732 Rev A (07/14)

Ease of Use

Great visibility allows

physician to watch the

lesion response and

adjust parameters

accordingly

AP0732 Rev A (07/14)

Key parameters for successful treatments

1. Wavelength532Pigment/Vascular

1064Deeper/Larger vessels

Pigment Vessels

2. Spot size

3. Pulse duration

4. Fluence

5. Cooling

Superficial vessels

Small individual vessels

Deep vessels

Large individual vessels

Smaller vessels

Smaller vascular volume

Larger vessels

Larger vascular volume

Low pressure vessels

Dark purple vessels

Larger vessels

High pressure vessels

Pink vessels

Smaller vessels

AP0732 Rev A (07/14)

excel VTM

532 nm KTP

AP0732 Rev A (07/14)

Absorption Spectrum

AP0732 Rev A (07/14)

532 nm KTP

AP0732 Rev A (07/14)

532 nm KTP Specifications

• Fluence: 1.8 - 42 J/cm2

• Spot Size: 2 – 12 mm

• Pulse Duration: 1.5 – 40 ms

• Repetition Rate: 0 to 4 Hz

AP0732 Rev A (07/14)

Pulse Width:

Getting the Ideal 1 – 10 ms Pulse• V-Beam pulses are too short

• Gemini pulses are too long

• Excel V pulses need to be just right

Gemini 532nm 7.5 J/cm2

20ms

AP0732 Rev A (07/14)

532 nm KTP : Telangiectasia

Treatment Parameters

532 nm : 4 mm, 10 J/cm2, 15 ms

Photos Courtesy of Neil Sadick, M.D.

Post One TxBefore

AP0732 Rev A (07/14)

532 nm KTP : Telangiectasia


532 nm : 4 mm, 19 J/cm2, 15 ms

Post One TxBefore


AP0732 Rev A (07/14)


532 nm : 7 J/cm2, 10 mm, 10 ms, 10°C

Photos Courtesy of Jeremy B. Green, M.D.

Post 3 Txs

532 nm KTP : Rosacea

AP0732 Rev A (07/14)


532 nm : 10 mm, 7 J/cm2, 12 ms

Post 4 TxsBefore



AP0732 Rev A (07/14)



532 nm : 10 mm, 7.4 J/cm2, 10 ms, 5˚C

Post 3 TxsBefore

Photos Courtesy of Mary Lupo, M.D.

AP0732 Rev A (07/14)


532 nm : 10 mm, 7.4 J/cm2, 10 ms, 5˚C

Post 2 TxsBefore

Photos Courtesy of Jeffrey Hsu, MD – Ashish Bhatia, M.D.


AP0732 Rev A (07/14)


Telangiectasia : 532 nm, 8.6 J/cm2, 5 mm, 10 ms, 10°C

Rosacea : 532 nm, 8 J/cm2, 10 mm, 9 ms, 10°C

Photos Courtesy of Macrene Alexiades, M.D., Ph.D

Post 2 TxsBefore

532 nm KTP : Telangiectasia, Rosacea and Photo-damage

AP0732 Rev A (07/14)


1064 nm : 3 mm, 10 ms, 120 J/cm2, 5°C

532 nm : 6 mm, 15 ms, 8 J/cm2, 5°C

Post One TxBefore

Photos Courtesy of Cesar Arroyo, M.D.

532 nm KTP : Spider Angioma

AP0732 Rev A (07/14)



532 nm : 5 mm, 13 J/cm2, 7 ms, 5˚C, 3 Pulses

Post One TxBefore


AP0732 Rev A (07/14)


532 nm : 6 mm, 6 J/cm2, 15 ms 10°C

Post One TxBefore



AP0732 Rev A (07/14)

Post One TxBefore

Photos Courtesy of Jeffrey Hsu, MD,/ Ashish Bhatia, M.D.


AP0732 Rev A (07/14)


532 nm : 10 mm, 15 ms, 6.6 J/cm2, 5°C

Post One TxBefore

Photos Courtesy of Joely Kaufman, M.D.

532 nm KTP : Poikiloderma

AP0732 Rev A (07/14)



532 nm : 10 mm, 7.4 J/cm2, 10 ms, 5˚C

Post 3 TxsBefore


AP0732 Rev A (07/14)


532 nm : 6.6 J/cm2, 10 mm, 12 ms, 10°C

Post 3 TxsBefore



AP0732 Rev A (07/14)


532 nm : 7 J/cm2, 7 mm, 6 ms, 5°C

Post One TxBefore

Photos Courtesy of Macrene Alexiades, M.D.

Immediately After Tx

532 nm KTP : Resistant Port Wine Stain

AP0732 Rev A (07/14)


532 nm : 12-16 J/cm2, 4-10 ms, 3 mm, 15°C

Post One TxBefore

Photos Courtesy of Grant Stevens, M.D.

532 nm KTP : Light Lentigines

AP0732 Rev A (07/14)


532 nm : 6mm, 10J cm2, 7ms, 15°C

8 Days Post One TxBefore

Photos Courtesy of Adam Gropper, M.D.

4 Days Post One Tx

532 nm KTP : Solar Lentigo

AP0732 Rev A (07/14)


532 nm : 7-7.2 J/cm2, 10 mm, 12 ms, 15°C - 1 pass w/ 20% OL

Post 2 TxsBefore

Photos Courtesy of David Vasily, M.D.

532 nm KTP : Vascular & Benign Pigment

AP0732 Rev A (07/14)


532 nm : 7-7.2 J/cm2, 10 mm, 12 ms, 15°C - 1 pass w 20% OL

Post 2 TxsBefore


532 nm KTP : Vascular & Benign Pigment

AP0732 Rev A (07/14)


1064 nm : 70J/cm2, 25ms, 7mm

532 nm : 7J/cm2, 8ms, 10mm

Post 9 TxsBefore

Photos Courtesy of CUTERA Clinic

532 nm KTP : Port Wine Stain

AP0732 Rev A (07/14)

43 yr. old male with injury playing soccer to right popliteal fossa on 9.22.2013

Kevin Smith MD FRCPC – Niagara Fall, Canada

Objective: To evaluate the efficacy of 532 nm KTP (excel V) for the treatment of bruise

Study Design: 1 male adult with bruise

Patient received 2 treatments

• Treatment Session 1 – 9.27.2013 Quadrant 1 : Nd:YAG 1064 nm – 9 mm, 60 J/cm2, 40 ms

Quadrant 2 : KTP 532 nm – 9 mm, 14 J/cm2, 20 ms

Quadrant 3 : IPL LimeLight - 1x3 cm spot, 20 J/cm2, Program A

Quadrant 4: Control area was not treated

• Treatment Session 2 – 9.28.2013 All 4 quadrants were treated with KTP 532 nm – 9 mm,

14 J/cm2, 20 ms

1

24

3

5 day old bruise

Photos Courtesy of Kevin Smith, M.D.

532 nm KTP : Clinical Validation

AP0732 Rev A (07/14)

532 nm KTP : Bruise : Treatment One



Treatment Session 1 – 9.27.2013 Quadrant 1 : Nd:YAG 1064 nm – 9 mm, 60 J/cm2, 40 ms Quadrant 2 : KTP 532 nm – 9 mm, 14 J/cm2, 20 ms Quadrant 3 : IPL LimeLight - 1x3 cm spot, 20 J/cm2, Program A Quadrant 4: Control area was not treated

Before 9.27.13 1 Day after session 1 - 9.28.13

Nd:YAG

KTP Contro

l

IPLNd:YAG

IPL

KTP Control

Photos courtesy of Kevin Smith, MD

AP0732 Rev A (07/14)



Treatment Session 2 – 9.28.2013 All Quadrants (entire bruise) treated using KTP: KTP 532 nm – 9 mm, 14 J/cm2, 20 ms

532 nm KTP : Bruise : Treatment Two

Photos courtesy of Kevin Smith, MD

Before Session 2 – 9.28.13 1 HOUR after Session 2 (KTP only)

AP0732 Rev A (07/14)


532 nm : 10 mm, 15 ms, 5 J/cm2, 10° C


Photos Courtesy of David Holcomb, M.D.

532 nm KTP : Bruising

AP0732 Rev A (07/14)

Immediately AfterTreatment Parameters

532 nm : 5 mm, 8-12 ms, 7 J/cm2, 10°C



532 nm KTP : Bruising

AP0732 Rev A (07/14)

excel VTM

1064 nm truPulseTM

AP0732 Rev A (07/14)

Wavelength Absorption Spectrum

AP0732 Rev A (07/14)

1064 nm Nd:YAG

AP0732 Rev A (07/14)

1064 nm truPulse Specifications

• Fluence: 2- 300 J/cm2

• Spot Size: 2 – 12 mm

• Pulse Duration: 5 – 60 ms


AP0732 Rev A (07/14)

1064 nm truPulse

• Neodymium yttrium aluminum garnet (Nd:YAG)

• Greater depth of penetration than other lasers (> 5 mm when used with epidermal cooling)

• Endpoint: disappearance (vasospasm) or bluish color change (thermocoagulation/thrombosis)

• Low melanin absorption (ideal for darker skin types)

AP0732 Rev A (07/14)

• Neodymium yttrium aluminum garnet (Nd:YAG)

• Greater depth of penetration than other lasers (> 5 mm when used with epidermal cooling)

• Endpoint: disappearance (vasospasm) or bluish color change (thermocoagulation/thrombosis)

• Low melanin absorption (ideal for darker skin types)

AP0732 Rev A (07/14)


1064 nm : 7 mm, 30 ms, 90 J/cm2

Post One TxBefore

Photos Courtesy of Hideko Yambe, M.D.

1064 nm truPulse : Venous Lake

AP0732 Rev A (07/14)


1064 nm : 3 mm, 10 ms, 140 J/cm2

Post 2 TxsBefore

Photos Courtesy of E. Victor Ross, M.D.

1064 nm truPulse : Venous Lake

AP0732 Rev A (07/14)

1064 nm truPulse : Chest Veins


1064 nm : 125 J/cm2, 5 mm, 30 ms, 5°C

Post One TxBefore


AP0732 Rev A (07/14)


1064 nm : 135(115) J/cm2, 5 mm, 25(30) ms, 5°C

Post 2 TxsBefore


1064 nm truPulse : Chest Veins

AP0732 Rev A (07/14)

1064 nm truPulse : Periorbital Vessel


1064 nm : Tx 1: 110 J/cm2, 4 mm, 35 ms, 5˚C – 17 Pulses

1064 nm : Tx 2: 110 J/cm2, 5 mm, 35 ms, 5˚C – 12 Pulses

Post 2 TxsBefore


AP0732 Rev A (07/14)


1064 nm : 100 J/cm2, 6 mm, 45 ms, 5°C

Post 2 TxsBefore



AP0732 Rev A (07/14)


1064 nm : 110 J/cm2, 5 mm, 45 ms, 5°C

Post One TxBefore


1064 nm truPulse : Forehead Veins

AP0732 Rev A (07/14)


1064 nm : 110 J/cm2, 5 mm, 30 ms, 5°C

Post One TxBefore



AP0732 Rev A (07/14)


1064 nm : 130 J/cm2, 5 mm, 30 ms, 5°C

Post 2 TxsBefore

Photos Courtesy of Ceasar Arroyo, M.D.

1064 nm truPulse : Telangiectasia

AP0732 Rev A (07/14)


1064 nm : 110 J/cm2, 5 mm, 40 ms, 5°C

532 nm : 10 J/cm2, 5 mm, 10 ms, 5°C

Post One TxBefore

1064 nm truPulse : Reticular Vein – Matting (Legs)

Photos Courtesy of Jeffrey Hsu, MD and Ashish Bhatia, M.D.

AP0732 Rev A (07/14)


1064 nm : 100-180 J/cm2, 5mm, 10-40 ms, 5°C

Post One TxBefore

Photos Courtesy of Jeffrey Hsu, MD and Ashish Bhatia, M.D.

1064 nm truPulse : Spider Veins

AP0732 Rev A (07/14)


1064 nm : 130 J/cm2, 6 mm, 10 ms, 5°C

Post 3 TxsBefore


1064 nm truPulse : Leg Veins

AP0732 Rev A (07/14)


1064 nm : 3 mm, 150 J/cm2, 15 ms

Post One TxBefore


1064 nm truPulse : Spider Veins

AP0732 Rev A (07/14)



1064 nm : 160 J/cm2 4mm, 25 ms, 5°C

1064 nm : 165 J/cm2, 6 mm, 40 ms, 5°C

Post 2 TxsBefore


AP0732 Rev A (07/14)



1064 nm : 160 J/cm2, 4mm, 25 ms, 5°C

1064 nm : 165 J/cm2, 6 mm, 40 ms, 5°C

Post 2 TxsBefore


AP0732 Rev A (07/14)

Warts Clinical Evidence

Summary of results: Long-Pulsed Nd:YAG Laser

Treatment of Warts[1]

• Overall clearance rate was 96%

369 patients with recalcitrant or untreated warts

21 patients were lost during follow-up

• 336 of the 348 treated warts were eradicated

“Long-pulsed Nd:YAG laser is safe and effective for the

removal or reduction of warts and is less dependent on

patient compliance than are other treatment options”[1]

[1] T, Y Han, et al, “Long-Pulsed Nd:YAG Laser Treatment of Warts: Report on a Series of 369 Cases” J Korean Med Sci 2009; 24: 889-93

Baseline 1-month post-1 Tx

Before and After Clinical Documentation

Photos Courtesy of David Weiss, DPM

AP0732 Rev A (07/14)

Genesis V Specifications

• Wavelength: 1064 nm

• Fluence: 4-7 J/cm2

• Spot Size: 8 mm

• Pulse Duration: 0.3 ms


• Epidermal Cooling: none

• Patented 1064 nm

Laser Genesis procedure targets the micro-vascularity with

microsecond high peak power pulse

• Safe for all skin types

AP0732 Rev A (07/14)

Genesis V : Proprietary Design, Micro-Second Pulse Technology

• Two aiming beams ensure correct working distance

• Temperature sensors for real time temperature

feedback

• Safe and effective treatment outcomes

AP0732 Rev A (07/14)

1064 nm Genesis V : Laser Genesis

Thermal imaging reveals even heating to target

AP0732 Rev A (07/14)

AP0732 Rev A (07/14)

Post 6 TxsBefore


1064 nm Genesis V : Laser Genesis : Diffuse Redness

AP0732 Rev A (07/14)

2 Months Post 6 TxsBefore


1064 nm Genesis V : Laser Genesis : Diffuse Redness

AP0732 Rev A (07/14)

2.5 Months Post 4 TxsBefore


1064 nm Genesis V : Laser Genesis : Acne Scars

AP0732 Rev A (07/14)

1064 nm Genesis V : Laser Genesis : Acne Scars

Post 6 TxsBefore

Photos Courtesy of Tomei & Ashraf Badawi, M.D.

AP0732 Rev A (07/14)

1064 nm Genesis V : Laser Genesis

4 Months Post 6 TxsBefore

Photos Courtesy of Tomei & Ashraf Badawi, M.D.

AP0732 Rev A (07/14)

1064 nm : truPulse + Genesis V


532 nm: 7 J/cm2 , 10 mm, 10 ms, 5°C

Post 2 TxsBefore


AP0732 Rev A (07/14)

1064 nm : truPulse + Genesis V


532 nm: 7 J/cm2 , 10 mm, 10 ms, 5°C

1064 nm (x2)

Post 2TxsBefore


AP0732 Rev A (07/14)

Before Post treatmentBaseline 1-month post-3 Tx

Photos Courtesy of Jodi Schoenhaus, DPM


AP0732 Rev A (07/14)

Highlights In Review

• Large spot, short pulse widths at therapeutic fluences

• Purpuric and Non-purpuric settings

• Excellent visibility

• Excellent, variable cooling

• Able to treat red/brown dyschromia in one pass

• Fast 2 Hz rep rate at 12 mm spot size

• Quick start up, quick cool down

• Real time calibration – saves time

• Genesis V handpiece can be added for non-ablative, no

downtime, skin revitalization

• Treats all parts of the body

• Indicated for all skin types

AP0732 Rev A (07/14)

• Industry leading research & development

Temperature sensor

Aiming beam

Pulse Counter

Real time calibration

AP0732 Rev A (07/14)

Temperature Monitoring

LED Color Temp

Range

Green 26-30 o C

Green 31-34 o C

Green 35-38 o C

Yellow 39-42 o C

Yellow 43-46 o C

Red 47-50 o C

AP0732 Rev A (07/14)

5mm Clinical Evidence

• Summary of results 16 weeks post final

treatment: (81%) showed either “complete clearance” or “moderate

to significant” clearance

(51%) showed “complete clearance” with 100% testing

negative for fungi

(16%) that showed no improvement had a turbidity of 10 at

baseline

Kimura, Takeuchi, Kinoshita et al. Journal of Drugs in Dermatology

Baseline 6-months-post-final-Tx


Photos Courtesy of David Weiss, DPM

Infected Area=23.6% Infected Area = 9.4%

AP0732 Rev A (07/14)

Baseline 6-months-post-final-Tx


Photos Courtesy of David Weiss, DPMInfected Area=23.6% Infected Area = 9.4%

Baseline 3-monthspost-final Tx

6-monthspost-final Tx


Photos Courtesy of Michael Uro, DPM

AP0732 Rev A (07/14)

Thank You.

Questions?

Excel V

Health & Medicine

Transcript of Excel V