Selective photothermolysis of spider veins and reticular varices with the long-pulsed Nd:YAG laser

Abstract

AbstractThe therapy of spider veins, telangiectasia and reticular veins of lower extremities can be successfully performed with sclerotherapy or by using the long pulsed (LP) Nd:YAG laser. A matter of discussion, however, is how should laser parameters – such as wavelength, fluence, pulse duration, number of pulses – be utilized for effective and selective photothermolysis treatment without any side effects. The selective photothermolysis was introduced in 1983 by Anderson and Parrish 1 as a concept in laser treatment, meaning the selective thermal destruction of the target tissue (the chromophores – the light-absorption molecule is here the blood vessel) using a specific laser light wavelength, with minimal injury to surrounding tissue (the skin). The effectiveness of the selective photothermolysis process using an LP Nd:YAG laser at 1064 nm for the treatment of leg veins telangiectasias up to 2 mm in diameter, is the result of 30-years clinical experience sustained by patient satisfaction and photo documentation. The use of double and triple pulses seems to be the key of success in treating even larger vessels and has demonstrated superior safety and efficacy. Even bigger telangiectasias, reticular veins or other dilated veins on neckline, upper abdomen or in the face can be successfully treated with the LP Nd:YAG laser.