Effects of 1064-nm Nd:YAG long-pulse laser on polidocanol microfoam injected for varicose vein treatment: a controlled observational study of 404 legs, after 5-year-long treatment

Lasers Med Sci. 2019 Sep;34(7):1325-1332. doi: 10.1007/s10103-019-02736-1. Epub 2019 Feb 1.

Abstract

Sclerotherapy continues to be the treatment of choice for varicose veins in the legs. However, isolated treatment using microfoam or lasers requires a high number of sessions to eliminate them. In 2013, we published results about the efficacy and safety 3 years after the combined treatment with microfoam injections and subsequent application of Nd:YAG laser. The aim of this paper is to clinically evaluate the treatment of varices in a control visit after 5 years, when polidocanol microfoam is used and is immediately irradiated in the tissue with 1064-nm Nd:YAG laser beam. The outcome persistence after 5 years was studied in the legs that had received combined treatment and had been studied 3 years after treatment. Patients were contacted by phone, interviewed, and examined with echo-Doppler. Out of the 259 patients who were contacted, 221 agreed to make the appointment, although in the end, only 202 came, which meant analysing 404 legs. At 5 years, the clearance rates were very high: patients were included in class CEAP C1 showing vessels of from 0.5 to 3 mm diameter. The patients showed a high level of satisfaction. Regarding adverse effects, only 4 cases of hypopigmentation described in the previous publication persisted. Although the action mechanisms between the microfoam and the Nd:YAG laser must still be elucidated, it is notable that combining microfoam with laser exposure obtained a complete, effective treatment of legs in only 2 sessions, with high clearance rates and high level of satisfaction among patients.

Keywords: Microfoam polidocanol; Nd:YAG laser; Reticular veins; Sclerotherapy; Spider veins; Varicose veins.

Publication types

  • Observational Study

MeSH terms

  • Combined Modality Therapy
  • Female
  • Humans
  • Lasers, Solid-State* / adverse effects
  • Leg / pathology*
  • Middle Aged
  • Patient Satisfaction
  • Polidocanol / administration & dosage*
  • Polidocanol / adverse effects
  • Polidocanol / therapeutic use*
  • Sclerosing Solutions / therapeutic use
  • Sclerotherapy / adverse effects
  • Treatment Outcome
  • Varicose Veins / drug therapy*
  • Varicose Veins / surgery*

Substances

  • Sclerosing Solutions
  • Polidocanol