Santa Casa de São Paulo School of Medical Science, São Paulo, Brazil.
Science Valley Research Institute, São Paulo, Brazil.
Int Angiol. 2023 Dec;42(6):457-464. doi: 10.23736/S0392-9590.23.05056-3. Epub 2023 Nov 16.
Telangiectasias and reticular veins are associated with aesthetic disorders. Sclerotherapy is the gold standard treatment, but long-pulsed 1064-nm Nd:YAG laser (LP1064 laser) is also used. No data on the human histological effects of these lasers are reported. The objective was to test different LP1064 laser parameters and their histological effects on the dermis, collagen, telangiectasias, and reticular veins.
This was a single-center, prospective, single-arm, case-control, human study. During surgery (dermolipectomy), the abdominal section of 10 female patients was irradiated with 6 different transdermal LP1064 laser parameters after anesthesia. Ten pieces with areas of varying irradiation were evaluated according to the characteristics of the vessels identified by area. In each piece, two irradiation areas were performed per group, totaling 12 irradiation areas per piece, with 120 regions later analyzed at the end of the ten samples. After removing the surgical product, histological sections were extracted, and the dermis, telangiectasias, and reticular veins were analyzed.
Histological analysis showed that exposition to six different parameters from LP1064 laser led to significant dermal layer separation and collagen alterations. The effects were inconsistent on the loss of endothelial cells, intravascular thrombus formation, and fusion of vascular walls for both telangiectasias and reticular veins. In reticular veins, effects on intravascular thrombus formation and vascular wall fusion were not observed.
The LP1064 laser in monotherapy with fixed settings did not lead to a consistent vascular lesion to promote immediate occlusion in telangiectasias and reticular veins. This strategy may not work as monotherapy for small vein treatment, but the possible late response to the LP1064 laser cannot be ruled out and require further investigation.
毛细血管扩张和网状静脉与美容障碍有关。硬化疗法是金标准治疗方法，但长脉冲 1064nmNd：YAG 激光（LP1064 激光）也被使用。没有关于这些激光对人体组织学影响的数据报告。目的是测试不同的 LP1064 激光参数及其对真皮、胶原、毛细血管扩张和网状静脉的组织学影响。
这是一项单中心、前瞻性、单臂、病例对照、人体研究。在手术（皮肤切除术）过程中，在麻醉后，用 6 种不同的经皮 LP1064 激光参数照射 10 名女性患者的腹部部位。根据所识别的血管特征，对不同照射面积的 10 个部位进行评估。在每个部位中，每个组进行 2 个照射区域，每个部位共进行 12 个照射区域，10 个样本结束后共分析 120 个区域。切除手术产品后，提取组织学切片，并分析真皮、毛细血管扩张和网状静脉。
组织学分析表明，LP1064 激光的 6 种不同参数暴露导致真皮层分离和胶原改变明显。对毛细血管扩张和网状静脉的内皮细胞丢失、血管内血栓形成和血管壁融合的影响不一致。在网状静脉中，未观察到对血管内血栓形成和血管壁融合的影响。
固定设置的 LP1064 激光单一疗法并未导致一致的血管病变，无法立即闭塞毛细血管扩张和网状静脉。这种策略可能不适用于小静脉的单一治疗，但不能排除对 LP1064 激光的可能晚期反应，需要进一步研究。
