Comparative Study of Cryo-Laser and Cryo-Sclerotherapy with Microclerotherapy

Rosukhovskiy D.A.

doi:https://doi.org/10.17116/flebo202115031144

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BACKGROUND

Compression microsclerotherapy (CM) in C1—C2 patients leads to moderate satisfaction with early outcomes and high incidence of adverse events. Combined method known as Cryo Laser and Cryo Sclerotherapy (CLACS) with a synergistic effect of laser and sclerotherapy may be an alternative.

OBJECTIVE

To compare an effectiveness of CM and CLACS and to investigate the effect of a topical gel based on Aescin, Heparin and Essential Phospholipids on the treatment outcomes.

MATERIAL AND METHODS

We observed 188 C1—C2 patients divided into 2 groups. A microsecond NdYAG 1064 nm laser with an energy density of 50—90 J/cm² was used for CLACS. After laser treatment of all dilated vessels, CM of the same vessels was performed with a Sodium Tetradecyl Sulfate solution 3% mixed with 40% glucose solution (1: 9). In the control group, only CM was used in the same fashion. The main criterion was changes in severity of TAE/reticular varicose veins before and after procedure. We analyzed the incidence of secondary TAE, hyperpigmentation, pain, volume of sclerosant, need for vein puncture and clot removal.

RESULTS

According to 5-point efficacy scale, mean score in 1—2 weeks after CLaCS and CM was 3.9±0.6 and 2.3±0.8, respectively. Secondary TAE were detected in 65% of cases after CM and 8.0% of patients after CLaCS. Severe matting followed by impairment of leg appearance was found in 2 (1.4%) patients after CLaCS and 9 (22%) patients after sclerotherapy (p<0.0001). Hyperpigmentation was detected in 5 and 21% of patients after CLaCS and CM, respectively (p=0.006). Mean VAS score during CM was 1.9±0.7, during CLaCS — 2.1±0.2 (p>0.05). No blood clots requiring aspiration were observed after CLaCS. After CM, these situations occurred in 11 (26.83%) cases. Application of gel based on Aescin, Heparin and Essential Phospholipids after CLaCS improved an effectiveness of procedure after 2 and 6—10 weeks (p<0.05).

CONCLUSION

CLaCS is followed by faster improvement of skin appearance, less incidence of hyperpigmentation and secondary TAE compared to CM. A combined gel based on Aescin, Heparin and Essential Phospholipids can lead to faster achievement of favorable aesthetic effect.

Keywords:

laser coagulation

telangiectasia

sclerotherapy

CLaCS

microsecond laser

NdYAG

matting

hyperpigmentation

Authors:

Rosukhovskiy D.A.

Institute of Experimental Medicine;
«Russian Railways Medicine» Hospital in Vyborg

Received:

12.04.2021

Accepted:

20.06.2021

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