13 PrinciplesSelective photocoagulation (not photothermolysis): longer pulses allow more thermal damage to vessel walls (methemoglobin?- Mordon S. et al. 2003)Aggressive cooling allows skin protectionBoth 1&2 protect darker skin types
14 Materials and methods: 20 consecutive female patients with:class I-III red telangiectasias,blue venulectasiasreticular 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.
15 Results:Significant clearance (at least 66%) was obtained in 1.8 sessions in 85 % of patients.The satisfaction was good in 95 % of patients.
16 Teleangectasie degli arti inferiori: principi di laser-Tx Inquadramento flebologicoScleroterapia dei vasi iniettabiliPrevenzione (Reflusso, abuso di UV, moto, calze)Visione (luce polarizzata)Raffreddamento cutaneo
21 Case description: Lt popliteal area (i. e 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 you’ll get the pictures in a few weeks). Parameters: 800 nm ed 45 j/cm2, 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: that’s 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 landmarkLandmark*
22 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, msec, 5W.Daily use of silicon sheath 2 mm
23 Conclusioni: sclero-laserterapia combinata Indicazioni per laserterapia vascolare degli arti inferiori:Assolute:matting“agofobia”allergiamalformazioni capillariangiomiRelative:vasi fra 0,7 mm e 1,5 mm:sclero-laserterapia combinataDopo 3 trattamenti532 nm, scanner, 3 msecPrima