Percutaneous laser coagulation of dilated intradermal veins: from theory to practice

Abstract

Review authors consider the current possibilities of percutaneous laser coagulation for telangiectasias and reticular veins, which are the most common cosmetic defects of vascular genesis, occurring in more than 80% of women of different age groups. This vascular pathology constituting an aesthetic defect and causing local physical discomfort is one of the most common indications for phlebosclerosing therapy and percutaneous laser coagulation. The authors present the most effective and safe guidelines for percutaneous laser coagulation based on analyses of a large volume of specialized literature. Due to the use of state-of-the-art Nd:YAG lasers, percutaneous laser coagulation is increasingly used in patients with various types of intradermal vein lesions and, owing to high efficiency and safety, has advantages over compression sclerotherapy by several criteria. Nd:YAG lasers can be divided into long- and short-pulse ones according to their technical characteristics. Long-pulse lasers provide coagulation of the target vessel due to a single pulse with a high energy density (fluence), while short-pulse lasers, on the contrary, generate a series of pulses to the target vein with a running time of fractions of a millisecond, which ensures the conversion of hemoglobin into methemoglobin with a ten-fold increased ability to absorb laser energy and convert it to heat. As the duration of the pulses generated by the device is a priori shorter than the thermal relaxation time, the risk of burns to the skin and paravasal structures almost completely disappears. The authors provide clinical examples of the application of Aerolase Neo device that utilizes MicroPulse technology to confirm the effectiveness and safety of shortpulse Nd:YAG lasers.