Intense pulsed light is a promising way for telangiectasias / reticular veins treatment: from pathogenesis to pronounced clinical outcomes

D. V. Demidion, D. A. Koryakin
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Abstract

Varicose veins are the most common pathology of peripheral vessels. A broader concept is the term chronic venous insufficiency (CVI), which, in addition to varicose veins, includes telangiectasias and reticular veins. Sclerotherapy is considered as the basis of treatment for reticular veins. However, the procedure has its drawbacks and side effects, which indicates the importance of implementing safer treatment methods. An alternative treatment for reticular veins is intense pulsed light. To illustrate the effectiveness and safety of IPL treatment for reticular veins, we present a clinical case of a patient aged 73 years with complaints of dark purple and bluish vessels. After clinical evaluation, diagnosis of reticular veins/telangiectasias was made (C 1 according to the CEAP 2020 classification). Due to the patients’ refusal to undergo sclerotherapy, it was decided to perform IPL procedures (M22, Lumenis). The patient’s reticular veins and telangiectasias were almost completely leveled out after the second session of IPL therapy; there was also no progress of CVI. No side effects were noted. The pathogenetic application of intense pulsed light in the treatment of reticular veins can be explained by decreasing the inflammatory process, integrating extracellular matrix, as well as inhibition of mast cell degranulation.
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强脉冲光是治疗毛细血管扩张症/网状静脉的有效方法:从发病机制到显著的临床效果
静脉曲张是外周血管最常见的病变。除静脉曲张外,还包括毛细血管扩张和网状静脉。硬化疗法被认为是治疗网状静脉的基础。然而,这种治疗方法有其缺点和副作用,这表明采用更安全的治疗方法非常重要。强脉冲光是治疗网状静脉的另一种方法。为了说明强脉冲光治疗网状静脉的有效性和安全性,我们提供了一个临床病例,患者 73 岁,主诉血管呈深紫色和淡蓝色。经过临床评估,患者被诊断为网状静脉/网状血管瘤(根据 CEAP 2020 分类,为 C 1)。由于患者拒绝接受硬化剂治疗,因此决定进行强脉冲光治疗(M22,Lumenis)。第二次强脉冲光治疗后,患者的网状静脉和毛细血管扩张几乎完全消失,CVI 也没有进展。没有发现任何副作用。强脉冲光治疗网状静脉的病理应用可以通过减少炎症过程、整合细胞外基质以及抑制肥大细胞脱颗粒来解释。
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