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A Safe and Fast Procedure for Treating Legs Varicosities

J. Moreno-Moraga(1), J. Royo de la Torre(1), D. Fernndez(1), J. Alcolea(2), A.


Smarandache(3), M.L. Pascu(3) , F. Lecrre(4) J. Aspiazu(5) and M.A. Trelles(2)
1.
2.
3.
4.
5.

Instituto Mdico Vilafortuny. Tarragona (Spain)


National Institute for Laser, Plasma and Radiation Physics. Bucharest (Romania)
Instituto Mdico Lser. Madrid (Spain)
Inselspital Bern, Suisse And Institute Gustave Roussy Pole Cancer Grand Paris (France)
Dermitek Bilbao (Spain)

Do you know a treatment


able to obtain
a full resolution
of legs varicosities in only
2 sessions (CEAP C:1)?

You can read about it:

How does it work

The results are much better


than expected
(POL + Laser)
WHY?
?
WHY?

Alshulers Extended Theory

Heater

Target

POL bubbles
Distance

Could POL improve lasers effect?

or
Could the Nd:YAG laser modify
chemical structure of POL?

WHAT IS POLIDOCANOL (POL)


1.- Aetoxisclerol (Polidocanol), C14H30O2 (CAS 3055-99-0), is
a polyethylene glycol ether of Lauryl alcohol, where the
average value of polymer is 9

2.- The ability of POL to sclerose blood vessels led to its use as
a sclerosant in the 1960s.

HOW DOES WORK THE POL

1.- SCLEROSANT:
. Modifying vascular endothelium
. Reach vessels that you cant see
2.- INCREASE OF MET-HEMOGLOBIN LEVEL
Van Dam J, Brugge W.R. Endoscopy of the Upper gastrointestinal tract. New Eng J of Med.
1999, 341(23): 1738-1748

Only POL

Only Laser

POL + Laser

POL + Laser

POL + Laser

POL + Laser

POL + Laser

POL + Laser

POL + Laser

POL + Laser

HOW interacts the Nd:YAG with POL

We exposed Aetoxisclerol at laser beam emitted by a pulsed


Nd:YAG laser at 1.06m
Measurement of the modifications of Polidocanol absorption spectra after exposure to NIR laser radiation,
A. SMARANDACHE, J MORENO-MORAGA, M. TRELLES, M. L. PASCU,

JOURNAL OF OPTOELECTRONICS AND ADVANCED MATERIALS Vol. 12, No. 9, September 2010, p. 1942 1945, IF 0.433/2009

WHAT DO YOU KNOW NOWADAYS ABOUT POL AND Nd:YAG


LASER

1.- POL: Ethanol + Lauromacrogol

2.- ETHANOL

Measurement of the modifications of Polidocanol absorption spectra after exposure to NIR laser radiation,
A. SMARANDACHE, J MORENO-MORAGA, M. TRELLES, M. L. PASCU,

JOURNAL OF OPTOELECTRONICS AND ADVANCED MATERIALS Vol. 12, No. 9, September 2010, p. 1942 1945, IF 0.433/2009

Absorption is due rather to the main components of the


tissue than POL proper

1.- POLIDOCANOL

2.- HEMOGLOBIN

Measurement of the modifications of Polidocanol absorption spectra after exposure to NIR laser radiation,
A. SMARANDACHE, J MORENO-MORAGA, M. TRELLES, M. L. PASCU,

JOURNAL OF OPTOELECTRONICS AND ADVANCED MATERIALS Vol. 12, No. 9, September 2010, p. 1942 1945, IF 0.433/2009

Ethanol absorbance could be able to alter POL chemical


structure?

1.- This absorbance can change the red atoms (O2)

2.- Altered molecule of POL is more efficient?

We havent found yet how it can be demonstrated

Measurement of the modifications of Polidocanol absorption spectra after exposure to NIR laser radiation,
A. SMARANDACHE, J MORENO-MORAGA, M. TRELLES, M. L. PASCU,

JOURNAL OF OPTOELECTRONICS AND ADVANCED MATERIALS Vol. 12, No. 9, September 2010, p. 1942 1945, IF 0.433/2009

POL liquid vs POL foam

BUBBLES OF POL FOAM: Light scattering


The effect of the laser light may be enhanced if the
Polidocanol is introduced as foam since than the light
scattering in the tissue becomes more important and the
absorption of the laser beam becomes larger.
So, we might have in this case a larger number of modified
Polidocanol molecules

HOW DOES THE Nd:YAG LASER WORK

1.- Heating of blood to damage the endothelium


and to achieve the veins closure
2.- Less than 6% of energy emitted for the
laser is absorbed

3.- The previous injection on POL can change the level of


absortion or can improve their usefulness

How does the POL and Nd:YAG LASER work together

1.- POL damages the vein endothelium

2.- The light scattering can increase blood


heating

3.- The increasing of level of methemoglobin increases


the laser absorbance
4.- The ethanol has a significant absorbance at 1064 nm and
modify POL structure

CONCLUSSIONS

1.- It is a safe treatment because:


POL is the most well known sclerosant
Nd:YAG laser, the classical laser for vein closure

2.- It is an interesting treatment because:


You can reach a complete resolution of leg
varicosities in only 2 sessions

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