Treatment of varicose veins of the lower limb with percutaneous Nd:YAG laser. Our 6-year experience

XII Congreso de la Sociedad Española de Láser Médico Quirúrgico.

Marbella from 14 to 16 May 2004.
J. Royo de la Torre, I. Sanz Alonso y J. Moreno Moraga.

This presentation describes in detail the specificity of 585, 910 and 1064 nm wavelengths for the treatment of vascular lesions.

Given that a 1064 nm wavelength presents the greater penetration, it is concluded that this type of laser, Nd-YAG laser, is the most indicated for the treatment of reticular varicose veins and telangiectasias of the legs.

Nonetheless, the absorption coefficient of Hb for 1064 nm is low, and thus high fluencies are required to achieve an effective photothermolysis. Untoward side effects such as pain, burns and hyperpigmentations appear as a result of using high fluencies. Conventional resources to obviate these side effects are pulse wavelength and the different systems for skin protection and skin cooling.

INSTITUTO MEDICO LÁSER, in collaboration with the LASER AND MOLECULAR BEAM UNIT OF THE UNIVERSIDAD COMPLUTENSE, have developed a new optimisation Nd:YAG system for varicose veins. The system has been called "Photodynamic therapy (PDT)" and consists in increasing the absorption coefficient of haemoglobin through the endovenous administration of polydocanol and to improve performance through an optical resonance phenomenon in virtue of the superficial tension resulting from the use of the polydocanol microfoam. In this manner, the photo thermal effect of the elemental emission of the Nd:YAG laser is increased 20 times.

The study presents an accumulated experience of over 800 patients treated with Nd:YAG and with other type of photodynamic therapy systems.

Results are based according to the number of failed treatments in telangiectasias, vessels of less than and more than 4 mm, and on the incidence of side effects.

The study concludes that the outcome expectations with photodynamic therapy are significantly higher than the single treatment with Nd.YAG. Based on the results from the Chi sq statistical test used, photodynamic therapy has been shown to be highly effective in all the groups of studied vessels with a very low incidence of undesirable side effects.

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