Dr. Dmitry Averyanov represented the clinic at the forum with a report on "Percutaneous laser photocoagulation as a treatment for telangiectasias and reticular veins." Telangiectasia, also called spider veins, are dilated intradermal veins less than 1.0 mm in diameter. Reticular varicose veins are dilated, tortuous varicose veins with a diameter of 1.0-3.0 mm.
The Cardiovascular Clinic at EMC treats these problems with sclerotherapy, successfully using percutaneous laser coagulation with a diode laser, the Dornier Lite Beam with a unique tip, the Angio Spot. Laser radiation primarily affects hemoglobin, which heats the blood in the spider veins, damaging the vascular wall. Obliteration of the vein causes the "blueness" of the treated area to disappear, which makes it seem as if the vessel has been removed. It takes a few days to weeks for the venous pattern to completely disappear after the laser treatment. Basically, the vein diameter is obliterated to 3 mm.
While some patients desire to have their veins become completely invisible, others only want to change the appearance of the veins for a better cosmetic effect. Therefore, before starting treatment, we investigate the patient's motives, and explain that it may require several sessions for the veins to completely disappear.
The procedure for the laser removal of spider veins:
Initial treatment.
Repeat the treatment after 6-8 weeks (if required).
Repeat the treatment 6 months after the second treatment (if required).
Monitoring and repeat treatment sessions to achieve the desired result.
Repeat treatment after 6 weeks is very important. The body goes into a reparative phase at the moment the initial treatment session ends, in an attempt to restore blood flow to the damaged veins and maintain the potential ability of blood to circulate in the treated vessels.
Six weeks is a very appropriate time to evaluate the initial treatment results and revisit the necessity of repeat treatment to the blood vessels that have seen a spontaneous restoration of blood flow. This repeat treatment plays an important role in shaping the final results of the treatment.
While many patients need only one or two sessions, the majority, according to our observations, require a third session. Each patient is individual with regard to the time needed for involution of obliterated veins.
For patients with a large number of subcutaneous veins, or those who are inclined to their development, we recommend once yearly monitoring examinations and corrective treatments.
In our experience, the adverse effects of laser treatment are minimal and short-lived, but patients should be aware of them. A possible adverse reaction is slight reddening of the skin, which can last up to several days. It can be easily hidden with the use of cosmetics. There may be very slight burns, sometimes with blisters. On average, they can last up to 10 days. There can rarely be minor intermittent hypo- or hyperpigmentation. This usually disappears in 2-3 months.