Histopathological evaluation of lower limb reticular veins treated with Nd:YAG 1064 nm laser: a prospective cohort pilot study

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: with pulse durations of 15 ms and 30 ms were significantly associated with the presence of inflammatory infiltrates (P0.05). CONCLUSIONS: combined with pulse durations of 15-30 ms.