Serum lipid changes following laser lipolysis.

BACKGROUND: Laser lipolysis allows the removal of small volumes of fat with concurrent sub-dermal tissue contraction. However, the physiologic consequences of this procedure are not well documented. The possible effects on serum lipids are not well established. OBJECTIVE: This study was undertaken to determine what changes, if any, occurred in serum lipid profiles at different intervals (1 day, 7 days, 2 weeks and 1 month) after the procedure. METHODS: Four consecutive patients were included in the study. In all patients, the right and left hips were treated with a 980-nm diode laser (Osyris Medical, Hellemmes, France). Power was tuned at 18 W. Cumulative energies varied from 22 000 J to 50 150 J. Fasting blood samples were obtained before the procedure and 1 day, 3 days, 2 weeks and 1 month after. A standard lipid profile (total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides) was done using the same laboratory facility for all tests. RESULTS: Serum cholesterol and triglyceride levels remained in the normal range after laser lipolysis. CONCLUSION: Two hypotheses can be proposed: (i) fat elimination is so gradual that an increase in circulating lipid levels is not measurable; (ii) the damaged adipocytes are undergoing apoptosis and being removed by phagocytosis, presumably via activated macrophages.

Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients.

BACKGROUND: In recent years, endovenous laser treatment (ELT) has been proposed to treat incompetent great saphenous veins (GSV). This study reports the long-term outcome of ELT in a series of 500 patients. METHODS: Incompetent GSV segments in 500 patients (436 women, 64 men) with a mean age of 52.6 years (range, 19 to 83 years) were treated with intraluminal ELT using a 980-nm diode laser (Pharaon, Osyris, France). The GSV diameter was measured by Duplex examination in an upright position in different GSV segments (1.5 cm below the saphenofemoral junction, crural segment, condylar segment, and sural segment). These measurements were used to determine the optimal linear endovenous energy density (LEED) for each segment. During treatment, patients were maintained in the Trendelenburg position. Patients were evaluated clinically and by duplex scanning at 1 and 8 days, 1 and 6 months, and at 1, 2, 3, and 4 years to assess treatment efficacy and adverse reactions. RESULTS: A total of 511 GSVs were treated. The mean diameter was 7.5 mm (range, 2.4 to 15.0). The LEED was tuned as a function of the initial GSV diameter measured in the orthostatic position, from 50 J/cm (3 mm) up to 120 J/cm (15 mm). At the 1-week follow-up, 9.3% of the patients reported moderate pain. In the immediate postoperative period, the closure rate was 98.0% and remained constant during the 4-year follow-up to reach 97.1%. After 1 year, a complete disappearance of the GSV or minimal residual fibrous cord was noted. Major complications have not been detected; in particular, no deep venous thrombosis. Ecchymoses were seen in 60%, transitory paresthesia was observed in 7%. There was no dyschromia, superficial burns, thrombophlebitis, or palpable indurations. Complementary phlebectomy was done in 98% of patients. Failures occurred only in large veins (saphenofemoral junction diameter >1.1 cm or for GSV truncular diameter >0.8 cm) CONCLUSION: ELT of the incompetent GSV with a 980-nm diode laser appears to be an extremely safe technique, particularly when the energy applied is calculated as a function of the GSV diameter. It is associated with only minor effects. Currently, ELT has become the method of choice for treating superficial veins and has almost replaced the treatment of traditional ligation and stripping.