Laser treatment of leg veins: Physical mechanisms and theoretical considerations.
OBJECTIVE
A discussion of laser treatment of leg veins is based on a review of the literature, theoretical analysis, and the clinical experiences of the authors. Theoretical computations are discussed within the context of clinical observations.


METHODS
A Monte Carlo model is used to examine volumetric heat production, fluence rate, and temperature profiles in blood vessels at 1,064 and 532 nm wavelengths with various beam diameters, vessel diameters, and pulse durations.


RESULTS
Clinical observations, Monte Carlo results, and a review of the literature suggest that longer wavelengths and longer pulses durations favor vessel contraction over intraluminal thrombosis. Monte Carlo simulations show that longer wavelengths are more likely to uniformly heat the vessel compared to highly absorbing wavelengths. Methemoglobin production causes deeply penetrating wavelengths to generate more volumetric heat for the same input radiant exposure.


CONCLUSIONS
Clinical observations and models support the role of long wavelengths and long pulses in optimal clearance of most leg telangiectasias.
Ross
Edward Victor
EV
Dermatology Department, Naval Medical Center San Diego, San Diego, California 92134-2300, USA. evross@nmcsd.med.navy.mil
Domankevitz
Yacov
Y
D006801:Humans; D007866:Leg / Q000098:blood supply; D028022:Low-Level Light Therapy / Q000379:methods*; D009010:Monte Carlo Method; D016544:Patient Simulation; D012680:Sensitivity and Specificity; D013684:Telangiectasis / Q000473:pathology / Q000532:radiotherapy*; D014648:Varicose Veins / Q000473:pathology* / Q000532:radiotherapy*