Transcutaneous laser treatment of leg veins

dc.creatorMeesters, AA
dc.creatorPitassi, LHU
dc.creatorCampos, V
dc.creatorWolkerstorfer, A
dc.creatorDierickx, CC
dc.date2014
dc.dateMAR
dc.date2014-08-01T18:20:48Z
dc.date2015-11-26T17:06:27Z
dc.date2014-08-01T18:20:48Z
dc.date2015-11-26T17:06:27Z
dc.date.accessioned2018-03-28T23:54:55Z
dc.date.available2018-03-28T23:54:55Z
dc.identifierLasers In Medical Science. Springer London Ltd, v. 29, n. 2, n. 481, n. 492, 2014.
dc.identifier0268-8921
dc.identifier1435-604X
dc.identifierWOS:000333051700011
dc.identifier10.1007/s10103-013-1483-2
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/77529
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/77529
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1279859
dc.descriptionLeg telangiectasias and reticular veins are a common complaint affecting more than 80 % of the population to some extent. To date, the gold standard remains sclerotherapy for most patients. However, there may be some specific situations, where sclerotherapy is contraindicated such as needle phobia, allergy to certain sclerosing agents, and the presence of vessels smaller than the diameter of a 30-gauge needle (including telangiectatic matting). In these cases, transcutaneous laser therapy is a valuable alternative. Currently, different laser modalities have been proposed for the management of leg veins. The aim of this article is to present an overview of the basic principles of transcutaneous laser therapy of leg veins and to review the existing literature on this subject, including the most recent developments. The 532-nm potassium titanyl phosphate (KTP) laser, the 585-600-nm pulsed dye laser, the 755-nm alexandrite laser, various 800-983-nm diode lasers, and the 1,064-nm neodymium yttrium-aluminum-garnet (Nd:YAG) laser and various intense pulsed light sources have been investigated for this indication. The KTP and pulsed dye laser are an effective treatment option for small vessels (< 1 mm). The side effect profile is usually favorable to that of longer wavelength modalities. For larger veins, the use of a longer wavelength is required. According to the scarce evidence available, the Nd:YAG laser produces better clinical results than the alexandrite and diode laser. Penetration depth is high, whereas absorption by melanin is low, making the Nd:YAG laser suitable for the treatment of larger and deeply located veins and for the treatment of patients with dark skin types. Clinical outcome of Nd:YAG laser therapy approximates that of sclerotherapy, although the latter is associated with less pain. New developments include (1) the use of a nonuniform pulse sequence or a dual-wavelength modality, inducing methemoglobin formation and enhancing the optical absorption properties of the target structure, (2) pulse stacking and multiple pass laser treatment, (3) combination of laser therapy with sclerotherapy or radiofrequency, and (4) indocyanin green enhanced laser therapy. Future studies will have to confirm the role of these developments in the treatment of leg veins. The literature still lacks double-blind controlled clinical trials comparing the different laser modalities with each other and with sclerotherapy. Such trials should be the focus of future research.
dc.description29
dc.description2
dc.descriptionSI
dc.description481
dc.description492
dc.languageen
dc.publisherSpringer London Ltd
dc.publisherLondon
dc.publisherInglaterra
dc.relationLasers In Medical Science
dc.relationLasers Med. Sci.
dc.rightsfechado
dc.rightshttp://www.springer.com/open+access/authors+rights?SGWID=0-176704-12-683201-0
dc.sourceWeb of Science
dc.subjectLaser
dc.subjectLeg vein
dc.subjectLeg vessel
dc.subjectVascular lesions
dc.subjectTelangiectasia
dc.subjectLower extremity
dc.subjectNd-yag Laser
dc.subjectPulsed-dye-laser
dc.subjectPort-wine Stain
dc.subjectLower-extremity Telangiectases
dc.subjectLong-pulse
dc.subject1064 Nm
dc.subjectReticular Veins
dc.subjectDiode-laser
dc.subjectAlexandrite Laser
dc.subjectIndocyanine Green
dc.titleTranscutaneous laser treatment of leg veins
dc.typeArtículos de revistas


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