Compressed air works most of the time, the majority of laptops have an intake vent and the dust and fluff will get blasted out, if it's so blocked that the build up has formed a "carpet" across the heatsink then striping is the only way, sometimes it can just be a panel on the base or take the keyboard off and extract the fluff with some tweezers, but if your handy its best to strip, clean then repaste but remove the original TIM if its the silver foil type.