Lasers in Medical Science

, Volume 34, Issue 7, pp 1325–1332 | Cite as

Effects of 1064-nm Nd:YAG long-pulse laser on polidocanol microfoam injected for varicose vein treatment: a controlled observational study of 404 legs, after 5-year-long treatment

  • Javier Moreno-Moraga
  • Mihail L. Pascu
  • Justo M. Alcolea
  • Adriana Smarandache
  • Josefina Royo
  • Fernández David
  • Mario A. TrellesEmail author
Original Article


Sclerotherapy continues to be the treatment of choice for varicose veins in the legs. However, isolated treatment using microfoam or lasers requires a high number of sessions to eliminate them. In 2013, we published results about the efficacy and safety 3 years after the combined treatment with microfoam injections and subsequent application of Nd:YAG laser. The aim of this paper is to clinically evaluate the treatment of varices in a control visit after 5 years, when polidocanol microfoam is used and is immediately irradiated in the tissue with 1064-nm Nd:YAG laser beam. The outcome persistence after 5 years was studied in the legs that had received combined treatment and had been studied 3 years after treatment. Patients were contacted by phone, interviewed, and examined with echo-Doppler. Out of the 259 patients who were contacted, 221 agreed to make the appointment, although in the end, only 202 came, which meant analysing 404 legs. At 5 years, the clearance rates were very high: patients were included in class CEAP C1 showing vessels of from 0.5 to 3 mm diameter. The patients showed a high level of satisfaction. Regarding adverse effects, only 4 cases of hypopigmentation described in the previous publication persisted. Although the action mechanisms between the microfoam and the Nd:YAG laser must still be elucidated, it is notable that combining microfoam with laser exposure obtained a complete, effective treatment of legs in only 2 sessions, with high clearance rates and high level of satisfaction among patients.


Sclerotherapy Varicose veins Spider veins Reticular veins Microfoam polidocanol Nd:YAG laser 


Funding information

The authors Mihail L. Pascu and Adriana Smarandache were supported by MCI through the Nucleu Programme (ctr. no. 1813/2018) and CNCS/CCCDI - UEFISCDI project PN-III-P2-2.1-PED-2016-0420.

Compliance with ethical standards

The interview and study methodology were approved by the Ethics Committee of the Fundación Antoni de Gimbernat, and all patients who agreed to participate at control visit for evaluation of the results signed an informed consent form.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Instituto Médico LáserMadridSpain
  2. 2.Laser DepartmentNational Institute for Laser, Plasma and Radiation PhysicsBucharestRomania
  3. 3.Clínica AlcoleaBarcelonaSpain
  4. 4.Fundación Antoni de GimbernatInstituto Médico VilafortunyTarragonaSpain

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