Rogachefsky Arlene S, Silapunt Sirunya, Goldberg David J
Skin Laser & Surgery Specialists of New York and New Jersey, Mt. Sinai School of Medicine, New York, New York 07601, USA.
Dermatol Surg. 2002 Mar;28(3):220-3. doi: 10.1046/j.1524-4725.2002.01141.x.
Laser treatment of lower extremity telangiectases and small reticular veins has remained difficult because of vessel color, diameter, depth, and associated high-pressure flow. Traditionally, larger-caliber blue leg veins do not respond well to laser treatment. Nd:YAG laser (1064 nm) irradiation is absorbed by oxyhemoglobin and reduced hemoglobin and is associated with greater depth of penetration than other previously studied vascular lasers.
To evaluate a millisecond contact-cooled 1064 nm Nd:YAG laser for the treatment of telangiectases and small reticular veins.
Twenty-one lower extremity sites, with Fitzpatrick skin types I-IV, received two laser treatments separated by a 4 to 6-week period. Blue and red vessels, ranging in size from 0.25 to 4.0 mm were treated. Pulse durations of 10-50 msec were utilized at fluences of 90-187 J/cm2. Three months after the last treatment, patients were evaluated for vessel improvement and complications.
Seventy-one percent of lower extremity vessels had improvement graded as significant. All vessel colors and sizes were successfully treated. The only complication at 3 months was postinflammatory hyperpigmentation.
1064 nm Nd:YAG laser irradiation with associated contact cooling is a safe and effective treatment for telangiectases and small reticular veins of the lower extremities.
由于血管颜色、直径、深度以及相关的高压血流，下肢毛细血管扩张和小网状静脉的激光治疗一直颇具难度。传统上，较大管径的蓝色腿部静脉对激光治疗反应不佳。钕钇铝石榴石激光（1064纳米）照射可被氧合血红蛋白和还原血红蛋白吸收，且与其他先前研究的血管激光相比，其穿透深度更大。
评估毫秒级接触冷却的1064纳米钕钇铝石榴石激光治疗毛细血管扩张和小网状静脉的效果。
对21个下肢部位（皮肤菲茨帕特里克分型为I - IV型）进行了两次激光治疗，间隔4至6周。治疗了大小从0.25至4.0毫米的蓝色和红色血管。脉冲持续时间为10 - 50毫秒，能量密度为90 - 187焦耳/平方厘米。最后一次治疗后三个月，对患者的血管改善情况和并发症进行评估。
71%的下肢血管改善程度为显著。所有血管颜色和大小均成功得到治疗。三个月时唯一的并发症是炎症后色素沉着。
1064纳米钕钇铝石榴石激光照射联合接触冷却对于下肢毛细血管扩张和小网状静脉是一种安全有效的治疗方法。
