Percutaneous laser coagulation of dilated intradermal veins: from theory to practice
https://doi.org/10.21518/akh2023-035
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.
About the Authors
V. Yu. Bogachev
Pirogov Russian National Research Medical University;
First Phlebological Center
Russian Federation
Russian Federation
Vadim Yu. Bogachev, Dr. Sci. (Med.), Professor of the Department of Faculty Surgery No. 2; Scientific Supervisor
1, Ostrovityanov St., Moscow, 117997;
31, Dmitry Ulyanov St., Moscow, 117447
H. P. Manjikian
Eramishantsev Moscow State Hospital;
Vishnevsky National Medical Research Center of Surgery
Russian Federation
Russian Federation
Hovsep P. Manjikian, Cardio-Vascular Surgeon, Head of Vein Clinic; Applicant
15, Lenskaya St., Moscow, 129327;
27, Bolshaya Serpukhovskaya St., Moscow, 117997
O. A. Alukhanyan
Kuban State Medical University
Russian Federation
Russian Federation
Ovik A. Alukhanyan, Dr. Sci. (Med.), Professor of the Department of Cardiac Surgery and Cardiology, Faculty of Vocational Education and Professional Retraining of Specialists
4, Mitrofan Sedin St., Krasnodar, 350063
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Bogachev V.Yu., Manjikian H.P., Alukhanyan O.A. Percutaneous laser coagulation of dilated intradermal veins: from theory to practice. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2023;20(2):17-26. (In Russ.) https://doi.org/10.21518/akh2023-035
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