RESUMO
Telangiectasias is most prevalent on the lower limbs and has been estimated to manifest in 40%-90% of the population. Treatments for telangiectasias include sclerotherapy, laser therapy, intense pulsed light treatment, microphlebectomy, and thermocoagulation. Cryo-Laser & Cryo-Sclerotherapy (CLaCS) effectively combines thermal and injection sclerotherapy. In this treatment, unwanted veins are targeted by a transdermal laser and immediately receive injection sclerotherapy. During the whole procedure, an air-cooling device (Cryo) blows onto the surrounding skin and tissue to prevent skin burn. Here, we present a case report of a challenging telangiectasias treated with ClaCS.
Assuntos
Realidade Aumentada , Terapia a Laser , Telangiectasia , Humanos , Perna (Membro)/irrigação sanguínea , Seguimentos , Extremidade Inferior , Escleroterapia/métodos , Telangiectasia/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Cryo-Laser & Cryo-Sclerotherapy (CLaCS) is a technique which combines thermal sclerotherapy and injection sclerotherapy. Telangiectasias and small varicosities are targeted by a transdermal laser and right after receive injection sclerotherapy. A cooling device blows -20°C air onto the skin and needle in a pre-, parallel-, and post-fashion. OBJECTIVE: Our objective was to establish if there is a difference in result and complications by varying the sclerosing agent but keeping the same ND:Yag long pulse laser parameters in the treatment of small varicosities. METHODS: Fifty five patients were enrolled prospectively and randomized to two groups; in the group 1 dextrose 75% was the sclerosing agent used in combination with the ND:Yag long pulse laser and, in the group 2, the same laser technique was used but the sclerosing agent was polidocanol 0.3% and dextrose 67%. RESULTS: The results were evaluated 30 days after the treatment by the patients and for blinded evaluators using before and after standardized photos with and without augmented reality. In the patient's perspective and in the blinded evaluation of the regular photos, no differences between the groups were found. Both groups had low rates of hyperpigmentation and bruising with no statistical difference. Patients treated with polidocanol had less pain after the treatment and a better clearance rate in the photos with augmented reality. No major complications were found. CONCLUSION: The treatment of small varicosities with CLaCS using Dextrose 75% or polidocanol 0.3% and Dextrose 67.5% is a safe and effective procedure and both sclerosing agents can be used with similar results. Possibly, in the polidocanol group more nonvisible reticular veins were cleared, but the implication of this find is not clear.