Long-pulsed Nd:YAG 1064nm in the treatment of leg veins: Check up of results at 6 months in 100 patients

Long-pulsed 1064nm Nd:YAG laser in the treatment of leg veins: Systematic review

OBJECTIVE

Long-pulsed 1064 nm Nd:YAG laser can damage vessels with higher diameters and penetrate to a deeper level than other laser therapies. We aim to analyze outcomes of the treatment of leg veins with long-pulsed 1064 nm Nd:YAG laser regarding intervention protocol, technical success, clinical success, and side effects.

METHODS

A research of the published literature was conducted, using PubMed and Embase databases, in April 2022. The key words used were telangiectasia, reticular veins, neodymium YAG laser, clearance, satisfaction, and treatment. PRISMA guidelines were followed.

RESULTS

We included twenty-six articles, twenty-three prospective and three retrospective studies, with a total of 1991 patients. The articles were organized in different sections according to the control group. The four outcomes were analyzed in each section. These studies showed that the long-pulsed 1064 nm Nd:YAG laser is a safe and very good option for the treatment of leg veins measuring up to 3 mm in diameter. Studies comparing long-pulsed 1064 nm Nd:YAG laser therapy and sclerotherapy showed similar clearance rates with no significant differences. However, sclerotherapy seemed to be less painful and to have faster clinical improvements. In two articles, Nd:YAG laser had better outcomes in the treatment of smaller vessels with less than 1 mm in diameter, than sclerotherapy alone. Treatment with polidocanol microfoam and Nd:YAG laser had better clearance rates than Nd:YAG laser alone in three studies. In the comparison of 1064 nm Nd:YAG laser therapy with other lasers and light sources, the studies had contradictory results.

CONCLUSION

Long-pulsed 1064 nm Nd:YAG laser is a valid therapeutic option for leg telangiectasia and reticular veins with great aesthetic outcomes and minor side effects. Nd:YAG laser therapy could be combined with sclerotherapy or other laser therapies or IPL in order to achieve better results. Serious side effects are rare, but the procedure is almost always accompanied by moderate tolerable pain.

Laser beams interaction with polidocanol foam: molecular background

OBJECTIVE

The goal of this study was to investigate the laser light scattering involved in the laser irradiation process of polidocanol foam samples.

BACKGROUND DATA

Clinical experimental results proved that exposure of tissues impregnated with foaming polidocanol to laser radiation emitted at 1064 nm improved the efficacy of the treatment. Previous absorption studies on Aethoxysclerol 2% solution before and after exposure to Nd:YAG (1064 nm) laser beam have not shown important spectral modifications of it.

MATERIALS AND METHODS

To achieve the purpose of this work, we produced polidocanol foam using the Tessari method. The batch was passed between the two syringes ~40 times. The resulting foam was stable for 5-6 min. A 10 mm optical cell containing the foam sample was introduced into a home-made Raman spectroscopy system, in which the laser radiation used to excite the Raman emission was the second harmonic (532 nm) of a pulsed Nd:YAG laser beam. The detection was made by a high resolution spectrograph and ICCD camera.

RESULTS

The obtained Raman spectra were more intense in foam form than in simple solution. The laser light elastic scattering produced a larger optical path of the beam in the sample, and consequently, a larger absorption of it by the foam components that enhance the laser Raman scattering.

CONCLUSIONS

The effect of the laser light may be expanded if the polidocanol is used as foam, because then the light scattering in the tissue becomes more important and the beam absorption becomes larger.