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Optimal and safe treatment of spider leg veins measuring less than 1.5 mm on skin type IV patients, using repeated low-fluence Nd:YAG laser pulses after polidocanol injection

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Abstract

Treatment of micro-veins of less than 1.5 mm with laser and with chemical sclerosis is technically challenging because of their difficulty to remedy. Laser treatment is even more difficult when dark phototypes are involved.Three groups of 30 patients each, skin type IV, and vessels measuring less than 1.5 mm in diameter, were enrolled for two treatment sessions 8 weeks apart: group A, polidocanol (POL) micro-foam injection; group B, Nd:YAG laser alone; and group C, laser after POL injection. Repeated 8-Hz low-fluence pulses, moving the hand piece over a 3-cm vein segment with an average of five laser passes maximum and with a total time irradiation of 1 s were used. Sixteen weeks after the second treatment, statistically, degree of clearance after examining photographs and patients satisfaction index, plotted on a visual analogue scale and comparing results of all three groups, results were significantly better for group C (p < 0.0001). No significant differences in complications were noticed between the three groups. Efficacy of combining POL and laser proved safe and satisfactory in 96 % of patients using low-fluence laser pulses with a total cumulative energy in the 3 cm venous segment, lower than that of conventional treatment. Very few and transient complications were observed. POL foam injection followed by laser pulses is safe and efficient for vein treatment in dark-skinned patients.

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Authors and Affiliations

  1. Instituto Médico Laser, Madrid, Spain

    Javier Moreno-Moraga, Josefina Royo & M. Jose Isarría

  2. Instituto Médico Vilafortuny, Fundacion Antoni de Gimbernat, Cambrils, Spain

    Esteban Hernández, Justo Alcolea & Mario Trelles

  3. National Institute for Laser, Plasma and Radiation Physics, Bucharest, Romania

    Mihail Lucian Pascu & Adriana Smarandache

Authors
  1. Javier Moreno-Moraga
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  2. Esteban Hernández
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  3. Josefina Royo
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  4. Justo Alcolea
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  5. M. Jose Isarría
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  6. Mihail Lucian Pascu
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  7. Adriana Smarandache
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  8. Mario Trelles
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Correspondence to Mario Trelles.

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Moreno-Moraga, J., Hernández, E., Royo, J. et al. Optimal and safe treatment of spider leg veins measuring less than 1.5 mm on skin type IV patients, using repeated low-fluence Nd:YAG laser pulses after polidocanol injection. Lasers Med Sci 28, 925–933 (2013). https://doi.org/10.1007/s10103-012-1180-6

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  • DOI: https://doi.org/10.1007/s10103-012-1180-6

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