International angiology : a journal of the International Union of Angiology · 2026
Histopathological evaluation of lower limb reticular veins treated with Nd:YAG 1064 nm laser: a prospective cohort pilot study.
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Coelho Felipe, Silveira Fernando T, Bignardi Paulo R, Mizubuti Glenio B, Virgini-Magalhães Carlos E, Poschinger-Figueiredo Douglas, de O Rodrigues Eduardo, de Oliveira Rodrigo G
Аннотация
BACKGROUND: The 1064 nm Nd:YAG transdermal laser is commonly used in the ambulatory treatment of lower limb reticular veins and telangiectasias. However, optimal laser parameters, particularly fluence and pulse duration, remain a subject of debate. In this prospective cohort pilot study, we evaluated the histopathological effects of different Nd:YAG 1064 nm laser settings on reticular veins to identify the parameter combinations most associated with vein wall damage.
METHODS: Patients scheduled for ambulatory phlebectomy received transdermal laser therapy 24 hours prior to surgery, using different combinations of fluence and pulse duration. A total of 15 vein segments were collected during phlebectomy, 12 treated with the laser and 3 untreated controls. All samples were stained with hematoxylin and eosin and independently analyzed by two blinded pathologists for neutrophilic infiltration, luminal thrombosis, and wall fibrosis.
RESULTS: Laser parameters of 70 J/cm2 with pulse durations of 15 ms and 30 ms were significantly associated with the presence of inflammatory infiltrates (P<0.05). No statistically significant differences were found when comparing fixed fluence with variable pulse durations or fixed pulse duration with variable fluences (P>0.05).
CONCLUSIONS: Nd:YAG 1064 nm transdermal laser induces histopathological inflammation in reticular veins, particularly when using fluence of 70 J/cm2 combined with pulse durations of 15-30 ms.
METHODS: Patients scheduled for ambulatory phlebectomy received transdermal laser therapy 24 hours prior to surgery, using different combinations of fluence and pulse duration. A total of 15 vein segments were collected during phlebectomy, 12 treated with the laser and 3 untreated controls. All samples were stained with hematoxylin and eosin and independently analyzed by two blinded pathologists for neutrophilic infiltration, luminal thrombosis, and wall fibrosis.
RESULTS: Laser parameters of 70 J/cm2 with pulse durations of 15 ms and 30 ms were significantly associated with the presence of inflammatory infiltrates (P<0.05). No statistically significant differences were found when comparing fixed fluence with variable pulse durations or fixed pulse duration with variable fluences (P>0.05).
CONCLUSIONS: Nd:YAG 1064 nm transdermal laser induces histopathological inflammation in reticular veins, particularly when using fluence of 70 J/cm2 combined with pulse durations of 15-30 ms.