title: 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.
abstract: OBJECTIVE
  To assess the efficacy and safety of a new method of clearing varicose veins in the long term. It consists of applying the long-pulsed Nd:YAG laser following the injection of polidocanol microfoam, in two consecutive sessions, treating both legs in full in each session.
  
  
  METHODS
  Randomized, Polidocanol-controlled, blind evaluation clinical trial comparing the results between 79 legs treated with Polidocanol and 517 treated with Polidocanol + Laser. Photographs were taken preoperatively and at three months, two years and three years after treatment, as well as patient self-assessments.
  
  
  RESULTS
  Polidocanol + Laser is much more effective than polidocanol microfoam in clearing venulectasias with a diameter under 4 mm (p < 0.001). After three years, clearing percentages of 89% (Class I veins), 94% (Class II veins) and 95% (Class III veins) are observed, in comparison to 15%, 18% and 17%, respectively when only polidocanol was applied. No unexpected adverse effects were found and 86% of patients stated they were Satisfied or Very Satisfied.
  
  
  CONCLUSIONS
  The method leads to safe, fast and apparently permanent results. The treatment session lasts less than 1 h, and could become a first-choice treatment for the removal of all types of varicose veins with a diameter under 4 mm.
authors.affiliation: Instituto Médico Láser, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Moreno-Moraga
authors.affiliation: National Institute for Laser, Plasma and Radiation Physics, Bucharest, Romania.
authors.forename: Adriana
authors.initials: A
authors.lastname: Smarandache
authors.affiliation: National Institute for Laser, Plasma and Radiation Physics, Bucharest, Romania.
authors.forename: Mihail L
authors.initials: ML
authors.lastname: Pascu
authors.affiliation: Instituto Médico Láser, Madrid, Spain.
authors.forename: Josefina
authors.initials: J
authors.lastname: Royo
authors.affiliation: Instituto Médico Vilafortuny, Cambrils, Tarragona, Spain imv@laser-spain.com.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Trelles
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D053844:Lasers, Solid-State; D007866:Leg / Q000098:blood supply; D008875:Middle Aged; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000009:adverse effects; D016037:Single-Blind Method; D013684:Telangiectasis / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome; D014648:Varicose Veins / Q000188:drug therapy / Q000628:therapy*; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols
keywords: Nd:YAG laser; Sclerotherapy; polidocanol; reticular veins; spider veins; varicose veins