Comparison of the varicose desease of low extremities veins treatment using sclerotherapy and transcutaneоus laser coagulation.

Abstract

To study the effectiveness of treatment of small varicose veins of the lower extremities and the formation of differentiated approach in the use of transcutaneous laser coagulation (TLC) and sclerotherapy, was formed two groups of patients with C1 clinical class by CEAP. In I group 72 patients underwent TLC by Nd: YAG laser radiation with a wavelength of 1064 nm, and in the II group 70 patients treated by liquid sclerotherapy. Depending on the diameter of veins, both groups were divided into three subgroups: patients with reticular veins, venulectasias, and telangiectasias. Groups were comparable in age and clinical status. Evaluation of results was performed in each group immediately after treatment, after 1 week and 3 months. Effectiveness evaluation criteria included subjective and objective data.

Analysis of complications in one weak after procedure demonstrates that patients of I group had maximum percentage of complications in the treatment of reticular veins, whereas after laser coagulation of telangiectasias these complications were not. The percentage of early complications of sclerotherapy was significantly higher compared to the TLC. Subjective evaluation after 3 months showed that TLC maximal result (100% of patients with improving state) was obtained in the treatment vessels with diameter of <1.0 mm, while sclerotherapy (95% patients) - in the treatment of reticular veins (2-4 mm). A late complications (scarring and secondary telangiectasias) were obtained after TLC of vessels with diameter of 2-4 mm, and was not found in the treatment of telangiectasias. In general, the treatment of reticular veins best score was obtained when using sclerotherapy, and treatment telangiectasias - at TLC.

Thus, reticular veins require treatment with liquid scleotherapy; venulectasias and telangiectasias can be effectively treated using equally both methods. The best results in the treatment of telangiectasias provide TLC with a radation wavelength of 1064 nm and individual choice of procedure mode.