After 5 sessions of LBO (scanned and 1000µ) at various fluences. 18 months follow up
Pre post2 post3 post5
Matting of the leg through normal magnifying illumination Matting of the leg through polarized light magnification
Wavelengths used for leg veins Visible (532, 578, 585, 595, 600) Infrared (755, , 940, 980, 1064) Intense Pulsed Light ( )
Absorption curve of the main chromophores Wavelength (nm) Absorption coefficient
Principles 1. Selective photocoagulation (not photothermolysis): longer pulses allow more thermal damage to vessel walls (methemoglobin?- Mordon S. et al. 2003) 2. Aggressive cooling allows skin protection 3. Both 1&2 protect darker skin types
Materials and methods: 20 consecutive female patients with: –class I-III red telangiectasias, –blue venulectasias –reticular veins were treated with a combination of 532 nm (1000μ, 9-12 j/cm2) and 810nm (4mm, j/cm2 ) lasers. Patients with significant venous circulatory impairment were excluded. Both treatments were applied with contact skin cooling. The results were examined by digital macrophotographic imaging and a patient evaluation scale.
Results: Significant clearance (at least 66%) was obtained in 1.8 sessions in 85 % of patients. The satisfaction was good in 95 % of patients.
Teleangectasie degli arti inferiori: principi di laser-Tx Inquadramento flebologico Scleroterapia dei vasi iniettabili Prevenzione (Reflusso, abuso di UV, moto, calze) Visione (luce polarizzata) Raffreddamento cutaneo
Case description: Lt popliteal area (i.e. back of the knee) of a 56 ys old woman with varices. (The rt leg has also been treated later and youll get the pictures in a few weeks). Parameters: 800 nm ed 45 j/cm 2, 50 msec, 1 Hz, chilled tip, 1 session. Treatment: slight pressure on the skin with the handpiece. Treat until the vein shrinks and disappears within a few seconds. Stop before you see the skin turning grayish: thats a burn days after treatment the veins are still present and full of coagulated blood, that I remove by squeezing it through small punctures in the skin and vein wall that are absolutely painless. This patient only used a mild cream after treatment: no bandages, compressive stockings nor activity limitations were adopted. *The preexisting little white scar is shown as a landmark Landmark*
24 ys old women, 2 ys after RA with multiple trauma and multiple orthopedic procedures including scar revisions. 2 months after: 5 monthly Tx with LBO 532nm, scanner, 2.5 msec, 5W. Daily use of silicon sheath 2 mm
Indicazioni per laserterapia vascolare degli arti inferiori: Assolute: matting agofobia allergia malformazioni capillari angiomi Relative: vasi fra 0,7 mm e 1,5 mm: sclero-laserterapia combinata Conclusioni: Dopo 3 trattamenti 532 nm, scanner, 3 msec Prima