{"id":4406,"date":"2021-02-08T19:14:03","date_gmt":"2021-02-08T18:14:03","guid":{"rendered":"https:\/\/claser-algerie.com\/fr\/?p=4406"},"modified":"2021-02-08T19:14:11","modified_gmt":"2021-02-08T18:14:11","slug":"varicositees-et-traitement-au-laser-nd-yag-long-pulse","status":"publish","type":"post","link":"https:\/\/claser-algerie.com\/fr\/varicositees-et-traitement-au-laser-nd-yag-long-pulse\/","title":{"rendered":"VARICOSITEES ET TRAITEMENT AU LASER ND YAG LONG PULSE"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Technique<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Le laser Nd:Yag est un laser solide constitu\u00e9 d\u2019un cristal&nbsp;: le YAG (Yttrium Aluminium Garnet). Il \u00e9met un faisceau d\u2019une longueur d\u2019onde de 1064 nm qui est peu absorb\u00e9 par l\u2019oxyh\u00e9moglobine et par la m\u00e9lanine mais un peu par l\u2019eau. Par ailleurs il pr\u00e9sente une bonne profondeur de p\u00e9n\u00e9tration cutan\u00e9e&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Indications<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ce laser est particuli\u00e8rement indiqu\u00e9 pour le traitement des varicosit\u00e9s des membres inf\u00e9rieurs surtout lorsqu\u2019elles sont bleut\u00e9es et de petit diam\u00e8tre. Par contre il faudra d\u2019abord s\u2019occuper des plus gros vaisseaux en amont afin de fermer les robinets d\u2019alimentation, donc pratiquer un bilan phl\u00e9bologique classique (Doppler) et les interventions \u00e9ventuelles n\u00e9cessaires (chirurgie, \u00e9cho-scl\u00e9roses\u2026). Comme pour des travaux de plomberie on doit r\u00e9parer les gros tuyaux avant de s\u2019occuper des petits. Il s\u2019agit d\u2019une prise en charge globale et on n\u2019intervient qu\u2019en dernier, apr\u00e8s un geste chirurgical ou des s\u00e9ances de scl\u00e9roth\u00e9rapie qui reste le traitement de r\u00e9f\u00e9rence.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D\u00e9roulement de la s\u00e9ance&nbsp;<\/strong>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">On ne se sert pas d\u2019anesth\u00e9sie car elle entraine une vasoconstriction qui g\u00eane la vision de ces vaisseaux. On utilise du froid pour diminuer la douleur car ce laser est un peu douloureux mais supportable si la s\u00e9ance ne s\u2019\u00e9ternise pas\u2026<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">L\u2019op\u00e9rateur va suivre le trajet de ces vaisseaux et tirera dessus avec le laser pour entrainer une disparition transitoire de ceux-ci ou un gros spasme. Ils seront donc toujours pr\u00e9sents \u00e0 la fin de la s\u00e9ance avec une petite r\u00e9action p\u00e9riph\u00e9rique de type \u00ab&nbsp;griffure de chat&nbsp;\u00bb<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Au cours de cette s\u00e9ance le m\u00e9decin pourra se servir d\u2019un appareil de transillumination au contact de la peau qui permet de mieux visualiser des vaisseaux plus profonds \u00e0 traiter.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Si besoin on appliquera une cr\u00e8me cicatrisante \u00e0 la fin de la s\u00e9ance mais il ne doit pas y avoir de plaie.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Comme apr\u00e8s une s\u00e9ance de scl\u00e9roth\u00e9rapie on pourra \u00eatre amen\u00e9 \u00e0 proposer une contention veineuse pendant quelques jours selon la gravit\u00e9<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Effets ind\u00e9sirables<\/strong>&nbsp;:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Parfois le laser provoque quelques fissures dans ces vaisseaux ce qui va entrainer un petit h\u00e9matome non douloureux mais inesth\u00e9tique.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Comme apr\u00e8s les scl\u00e9roses certains vaisseaux resteront tr\u00e8s marqu\u00e9s pendant quelques mois, c\u2019est \u00e0 dire qu\u2019ils deviennent plus bleus qu\u2019avant ou m\u00eame carr\u00e9ment brun\u00e2tres mais tout s\u2019att\u00e9nue spontan\u00e9ment avec le temps.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>R\u00e9sultats<\/strong>&nbsp;:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Les r\u00e9sultats sont globalement bons pour les varicosit\u00e9s de 0,2 \u00e0 4 mm surtout en compl\u00e9ment de la scl\u00e9roth\u00e9rapie.\u00bb\u2026<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D\u2019autres longueurs d\u2019onde ont \u00e9t\u00e9 mises en avant pour traiter cette pathologie (Alexandrite, diode \u00e0 980nm, IPL avec un filtrage des ondes courtes\u2026) avec des r\u00e9sultats int\u00e9ressants mais ils ne sont pas toujours faciles \u00e0 utiliser. On peut aussi se servir du laser KTP \u00e0 532nm ou \u00e0 colorant puls\u00e9 pour traiter des minuscules varicosit\u00e9s rouges inaccessibles \u00e0 la scl\u00e9rose (par ex. \u00e0 la face interne des genoux)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Technique Le laser Nd:Yag est un laser solide constitu\u00e9 d\u2019un cristal&nbsp;: le YAG (Yttrium Aluminium Garnet). Il \u00e9met un faisceau d\u2019une longueur d\u2019onde de 1064 nm qui est peu absorb\u00e9 par l\u2019oxyh\u00e9moglobine et par la m\u00e9lanine mais un peu par l\u2019eau. Par ailleurs il pr\u00e9sente une bonne profondeur de p\u00e9n\u00e9tration cutan\u00e9e&nbsp; Indications Ce laser est [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4407,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4406","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-maladie-de-peau"],"_links":{"self":[{"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/posts\/4406","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/comments?post=4406"}],"version-history":[{"count":1,"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/posts\/4406\/revisions"}],"predecessor-version":[{"id":4408,"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/posts\/4406\/revisions\/4408"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/media\/4407"}],"wp:attachment":[{"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/media?parent=4406"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/categories?post=4406"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/claser-algerie.com\/fr\/wp-json\/wp\/v2\/tags?post=4406"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}