Treatment of Reticular Veins with a Long-pulsed 1064 nm Nd:YAG Laser: a Pilot Study

Bukina O.V.

doi:https://doi.org/10.17116/flebo20251902170

Bukina O.V.

Derzhavin Tambov State University;
Clinic «Doctor Profi»

ORCID: 0000-0002-7408-6973

Treatment of Reticular Veins with a Long-pulsed 1064 nm Nd:YAG Laser: a Pilot Study

Authors:

Bukina O.V.

More about the authors

Journal: Journal of Venous Disorders. 2025;19(2): 70‑76

DOI: 10.17116/flebo20251902170

Read: 939 times

To cite this article:

Bukina OV. Treatment of Reticular Veins with a Long-pulsed 1064 nm Nd:YAG Laser: a Pilot Study. Journal of Venous Disorders. 2025;19(2):70‑76. (In Russ., In Engl.)
https://doi.org/10.17116/flebo20251902170

Подписка 2026 Флебология (Journal of Venous Disorders)

Использование инфографики авторами научных работ

Close metadata

OBJECTIVE

To calculate the optimal Nd:YAG laser parameters for reticular vein treatment and check their efficacy and safety.

MATERIAL AND METHODS

A pilot study included female volunteers aged 30-67 years with C1 reticular veins who were treated with 1064 nm Nd:YAG laser. Disappearance of vessels and side effects were analyzed after 1, 2 and 6 months using a 6-point scale (0 — no change, 5 — no vein). Pain sensation was measured using the Visual Analogue Scale (VAS). Outcome satisfaction was assessed using a 3-point scale (from 0 to 2), skin hyperpigmentation — using skin hyperpigmentation index (SHI).

RESULTS

The following laser parameters for reticular veins were established: spot size — 7 mm, pulse length — 50 msec, energy — 140 J/cm². Seven female volunteers completed 6-month follow-up. The median score of vessel clearing (interquartile range, IQR) was 5 (3—5) after six months, patient satisfaction — 1.5 (1—2) points, pain during the procedure — 5 (2.5—5.75) points. Hyperpigmentation was observed in 6 patients (86%) after one month and in 4 patients (57%) after six months. There was moderate hyperpigmentation after treatment and mild by the end of the follow-up (SHI 1.09 (1.01—1.125)). Telangiectatic matting developed in one patient. There were no other side effects.

CONCLUSIONS

Reticular veins of the lower extremities can be treated using the Nd:YAG laser with the specific parameters calculated for reticular veins during the study. But hyperpigmentation occurs frequently and persists for six months and more, perhaps the same as after sclerotherapy. A comparative study of the Nd:YAG laser with sclerotherapy alone and a combined treatment of the Nd:YAG laser and sclerotherapy needs to be carried out.

Keywords:

reticular veins

long-pulsed 1064-nm Nd:YAG laser

hyperpigmentation

Authors:

Bukina O.V.

Derzhavin Tambov State University;
Clinic «Doctor Profi»

ORCID: 0000-0002-7408-6973

Received:

25.01.2025

Accepted:

16.03.2025

Close metadata

References:

Beebe-Dimmer JL, Pfeifer JR, Engle JS, Schottenfeld D. The epidemiology of chronic venous insufficiency and varicose veins. Ann Epidemiol. 2005;15:175-184. https://doi.org/10.1016/j.annepidem.2004.05.015
De Maeseneer MG, Kakkos SK, Aherne T, Baekgaard N, Black S, Blomgren L, Giannoukas A, Gohel M, de Graaf R, Hamel-Desnos C, Jawien A, Jaworucka-Kaczorowska A, Lattimer CR, Mosti G, Noppeney T, van Rijn MJ, Stansby G, Esvs Guidelines Committee, Kolh P, Bastos Goncalves F, Chakfé N, Coscas R, de Borst GJ, Dias NV, Hinchliffe RJ, Koncar IB, Lindholt JS, Trimarchi S, Tulamo R, Twine CP, Vermassen F, Wanhainen A, Document Reviewers, Björck M, Labropoulos N, Lurie F, Mansilha A, Nyamekye IK, Ramirez Ortega M, Ulloa JH, Urbanek T, van Rij AM, Vuylsteke ME. Editor’s Choice ‒ European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63:184-267. https://doi.org/10.1016/j.ejvs.2021.12.024
Rabe E, Breu FX, Cavezzi A, Coleridge Smith P, Frullini A, Gillet JL, Guex JJ, Hamel-Desnos C, Kern P, Partsch B, Ramelet AA, Tessari L, Pannier F; Guideline Group. European guidelines for sclerotherapy in chronic venous disorders. Phlebology. 2014;29(6):338-354. https://doi.org/10.1177/0268355513483280
Sadick NS. Long-term results with a multiple synchronized-pulse 1064 nm Nd:YAG laser for the treatment of leg venulectasias and reticular veins. Dermatol Surg. 2001;27:365-369. https://doi.org/10.1046/j.1524-4725.2001.00295.x
Egorova EA, Kalinin RE, Suchkov IA. Complications after Laser Treatment. Journal of Venous Disorders. 2024;18(4):317-327. (In Russ.). https://doi.org/10.17116/flebo202418041317
Ianosi G, Ianosi S, Calbureanu-Popescu MX, Tutunaru C, Calina D, Neagoe D. Comparative study in leg telangiectasias treatment with Nd:YAG laser and sclerotherapy. Exp Ther Med. 2019;17:1106e12. https://doi.org/10.3892/etm.2018.6985
Moreno-Moraga J, Smarandache A, Pascu ML, Royo J, Trelles MA. 1064 nm Nd: YAG long pulse laser after polidocanol microfoam injection dramatically improves the result of leg vein treatment: a randomized controlled trial on 517 legs with a three-year follow-up. Phlebology. 2014;29:658-666. https://doi.org/10.1177/0268355513502786
Parlar B, Blazek C, Cazzaniga S, Naldi L, Kloetgen HW, Borradori L, Buettiker U. Treatment of lower extremity telangiectasias in women by foam sclerotherapy vs. Nd:YAG laser: a prospective, comparative, randomized, open-label trial. J Eur Acad Dermatol Venereol. 2015;29:549e54. https://doi.org/10.1111/jdv.12627
Ross EV, Domankevitz Y. Laser treatment of leg veins: Physical mechanisms and theoretical considerations. Lasers Surg Med. 2005;36(2):105-116. https://doi.org/10.1002/lsm.20141
Parlette EC, Groff WF, Kinshella MJ, Domankevitz Y, O’Neill J, and Ross EV. Optimal pulse durations for the treatment of leg telangiectasias with a neodym YAG laser. Lasers Surg Med. 2006;38:98-105. https://doi.org/10.1002/lsm.20245
Bossart S, Willenberg T, Ramelet A-A, Cazzaniga S, Hunger RE, Jafari SMS. The skin hyperpigmentation index: An objective method of measuring the intensity of hyperpigmentation after sclerotherapy. Phlebology. 2020;35(10):833-835. https://doi.org/10.1177/0268355520941359
Major A, Brazzini B, Campolmi P, Bonan P, Mavilia L, Ghersetich I, Lotti T. Nd:YAG 1064 nm laser in the treatment of facial and leg telangiectasias. Journal of the European Academy of Dermatology and Venereology. 2001;15(6):559-565. https://doi.org/10.1046/j.1468-3083.2001.00354.x
Omura NE, Dover JS, Arndt KA, Kauvar AN. B. Treatment of reticular leg veins with a 1064 nm long-pulsed Nd:YAG laser. Journal of the American Academy of Dermatology. 2003;48(1):76-81. https://doi.org/10.1067/mjd.2003.38
Özden MG, Bahçivan M, Aydin F, Şentürk N, Bek Y, Cantürk T, Turanli AY. Clinical comparison of potassium-titanyl-phosphate (KTP) versus neodymium:YAG (Nd:YAG) laser treatment for lower extremity telangiectases. Journal of Dermatological Treatment. 2010;22(3):162-166. https://doi.org/10.3109/09546631003649679
Eremia S, Li CY. Treatment of leg and face veins with a cryogen spray variable pulse width 1064-nm Nd:YAG laser-a prospective study of 47 patients. J Cosmet Laser Ther. 2001;3(3):147-153. https://doi.org/10.1080/147641701753414960
Eremia S, LI C, Umar SH. A Side–by–Side Comparative Study of 1064 nm Nd. Dermatologic Surgery. 2002;28(3):224-230. https://doi.org/10.1046/j.1524-4725.2002.01162.x
Rogachefsky AS, Silapunt S, Goldberg DJ. Nd:YAG Laser (1064 nm) Irradiation for Lower Extremity Telangiectases and Small Reticular Veins: Efficacy as Measured by Vessel Color and Size. Dermatologic Surgery. 2002;28(3):220-223. https://doi.org/10.1046/j.1524-4725.2002.01141.x
Sadick NS. Laser Treatment With a 1064-nm Laser for Lower Extremity Class I-III Veins Employing Variable Spots and Pulse Width Parameters. Dermatologic Surgery. 2003;29(9):916-919.