1. All patients were score 9 or 6!
Case Report of 195 Patients Classified by Duplex Scanning and Augmented Reality,
and treated by Cryo-Laser &Cryo-Sclerotherapy (CLaCS): Results and Complications
Kasuo Miyake, MD, PhD Abstract No 914
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Objectives / Purpose Statement:
Duplex Scanning (DS) and Augmented Reality (AR) (projection of infra-red image of veins onto the skin) are new semiotic tools to a phlebology clinic. Transdermal laser is now capable of selective photothermolisis and the synergy with Dextrose75% sclerotherapy allows a more effectiveness1. This technique was designed to be free complications such as skin ulcers2, anaphylaxis and embolism. Objective:
Q1- calculate the prevalence of saphenous vein insufficiency in the population evaluated
Q2- evaluate treatment outcome
Q3- evaluate complications
-20ºC
air cooling
Method:
Case report of 195 patients consecutive patients in a private phlebology clinic focused on aesthetic result. Conducted between August 2011 and June 2012.
Examination: All patients were evaluated/treated by the author following the sequence: history, examination, duplex scanning, photo-pletismography, augmented reality, photo documentation (25 to 50 photos every session/consultation).
Photos 1, 2, 3 and 4 (method): CLaCS session: AR guidance -> trans-dermal laser shots -> Endothelium burning nad tunica media swelling -> vein gets partially contracted after 0-10min -> AR detects best spots to do the injection sclerotherapy (Dextrose75%) and achieve the desired synergy. 1+1=3 effect: thermal effect + osmotic effect + Dextrose75% trapped because of vein collapse caused by laser shots.
-20ºC
air cooling CT ST nT CV 9 8 7 SV 6 5 4 nV 3 2 1
References
1- K Miyake, H Miyake. PhotoDerm VL on darker skin. In: ANNUAL CONGRESS – NORTH AMERICAN SOCIETY OF PHLEBOLOGY, 10., Washington DC, Proceedings. Washington DC, 1996.
2- K Miyake, J T King, R Kikuchi, F H Duarte, J R P Davidson and C Oba. Role of injection pressure, flow and sclerosant viscosity in causing cutaneous ulceration during sclerotherapy. Phlebology 2012;27:383–389.
- K Miyake, F H Duarte, R Kikuchi,, J R P Davidson. Score 9-1 to Direct Patients to Phlebectomy – abstract presented at the 22nd Annual Congress f the American College of Phlebology, November 9th, 2008 (3rd Place Poster Abstract Award).
- Vein Imaging: A New Method of Near Infrared Imaging, Where a Processed Image Is Projected onto the Skin for the Enhancement of Vein Treatment. Kasuo Miyake, MD, PhD, Herbert David Zeman, PhD, Flavio Henrique Duarte, MD, Rodrigo Kikuchi, MD, Eduardo Ramacciotti, MD, PhD, Gunnar Lovhoiden, PhD, and Carlos Vrancken. Dermatol Surg 2006;32:1031–1038.
<- Q1
<- Q2
Table 1: Superficial Venous Score 9-1:
C: combined
S: Simple
V: varicosity
T: Telangiectasia
n: No
<- Q2
Photos 5 and 6: before (left) and after (right) one session of CLaCS. One month after 1064nm ND(YAG) 6mm spotsize laser 90j/cm2 15msec and Dextrose 75% 27 ½ needle and 3ml syringe
<- Q2
All patients were score 9 or 6!
<- Q2
<- Q3
Conclusions:
Duplex Scanning and Augmented Reality evaluation helps on diagnostic accuracy. All patients had feeder veins under the telangiectasias. Cryo-Laser and Cryo Sclerotherapy (D75%) guided by Augmented Reality is a new, effective and safe method. As soon as other groups starts to use the method in different populations it will be possible to have more conclusions about advantages and disadvantages (such as price of the devices). The lack of use of augmented reality in sample selection may be a bias to all telangiectasia treatment trials
<- Q3