Unfortunately, vascular diseases have a global status.People of different ages and genders are susceptible to it.Various reasons can contribute to the development of varicose veins in the lower extremities, and there are a number of them.Therefore, the statistics on registration of vascular diseases are increasing inexorably.At the same time, science and medicine do not stand still and the number of treatment methods is already impressive.
The choice of therapy regimen is left to the treating physician.Its selection is determined by the stage at which vascular pathology is detected, the dynamics of the disease, the general health of the patient and other factors.The specialist can, at his own discretion, include conservative, surgical methods or their symbiosis in the treatment regimen.
Conservative methods include drug and non-drug therapies.These treatment methods may be the only ones in the initial stages of the disease, when the first signs appear, and in 100% of cases they are an adjunct to surgical methods.
Expert opinion
Surgical methods are used in advanced forms of vascular pathology.Surgical methods are divided into invasive and minimally invasive methods.They all have indications and contraindications, as well as their advantages and disadvantages.
One of the most popular modern therapy methods is the EVLT procedure (endovasal laser coagulation) of the veins of the lower extremities.It is difficult for an untrained person to understand medical terms.Therefore, the question arises: what is it and what is it for?
EVLT of the veins of the lower extremities: preparation, procedural technology, indications and contraindications
What is EVLT treatment for varicose veins?Endovascular or endovenous laser coagulation of the veins of the lower extremities (EVLC) is a minimally invasive procedure to eliminate varicose veins.
How is endovascular laser coagulation of varicose veins performed?This method has been practiced for about ten years, so the process has been improved to this day.EVLT is characterized as a high-tech and quite complex manipulation, which requires not only high-quality equipment, but, above all, high professional training of medical personnel.
This is a percutaneous intravascular surgical procedure.This means that during laser coagulation of varicose veins on the legs, a peripheral catheter is inserted into the vein bed.A thin laser light guide penetrates through this to cauterize the veins.Under its influence, a thermal burn occurs and subsequent adhesion of the vein wall with obliteration of the lumen.The procedure is performed under local anesthesia (a low-concentration mixture of anesthetics).The effects are expected to last 6 to 10 hours.By adding vasoconstrictors to the mixture, in addition to the anesthetic effect, a vasoconstrictor effect is also achieved.This reduces the risk of hematoma formation after EVLT.
All phases of EVLT are performed using duplex scanning.
The specialist then checks the laser and its position in the vein.Without taking into account the pre-marking of the veins, laser treatment of varicose veins takes about 40 minutes.If necessary, sclerotherapy or miniphlebectomy of large varicose veins of the large and small saphenous veins is performed the next day.This is because endovascular laser photocoagulation has limitations regarding the allowable expansion of varicose veins of the great saphenous vein (GSV) and the small saphenous vein.For the procedure to be effective, the veins must be up to 25 mm in diameter.So if some veins remain visible after EVLT treatment, there is no need to worry.They can be eliminated by inserting sclerosant into the vein opening or by performing a puncture and then pulling out and physically removing the vein.As research results show, in such cases there is a good clinical and lasting cosmetic effect in the postoperative period, without signs of relapse.In addition, in general, the social rehabilitation of patients is accelerated (if they start following medical recommendations immediately after the operation).
Laser coagulation of blood vessels on the legs: preparatory phase
What is preparation for coagulation?The preparation is not difficult.In order for endovascular laser coagulation of the veins of the lower extremity to be performed, it is necessary:
- general examination of the patient's health status (general clinical blood and urine tests, blood test for RW, comprehensive analysis of blood clotting indicators, blood tests for viral hepatitis B and C, AIDS, HIV and syphilis);
- Examination of veins and blood vessels (USDS);
- Therapist's conclusion about the absence of contraindications.
It is necessary to prepare medical compression stockings in advance.
You will need it immediately after laser varicose vein treatment (EVLT).As a rule, the doctor prescribes knitwear of compression class II.
EVLT of the veins of the lower extremities: indications and contraindications
When laser coagulation of blood vessels in the legs is prescribed, there are only a few indications: the presence of varicose veins (from stage 2 after CEAP), trophic disorders of the lower leg, straight veins.
Such vein removal also has a number of contraindications:
- overweight (obesity);
- Diseases of the arteries of the lower extremities, accompanied by the formation of atherosclerotic plaques on the inner walls of blood vessels;
- limited movement of the patient due to diseases of the musculoskeletal system, stroke, etc.;
- infectious diseases;
- inflammatory processes of the skin and subcutaneous tissue;
- high blood pressure in the acute stage;
- some chronic diseases in the acute stage.
Is EVLT possible for blood clots?The prerequisite for the operation is the absence of blood clots in the upper section of the saphenous vein trunk.Therefore, the presence of blood clots is also a contraindication.
Is laser venous coagulation allowed during pregnancy and until when?
Expert opinion
EVLT surgeries are prohibited during pregnancy and postpartum, as well as while breastfeeding.Non-drug methods of conservative therapy are recommended for pregnant and breastfeeding women because... all possible risks to intrauterine development and the health of the child that has already been born must be excluded.
Rehabilitation after laser coagulation of the veins of the lower extremities
Those who are prescribed EVLT (laser subcutaneous coagulation) of the veins of the lower extremities are wondering whether it is necessary to open a sick leave certificate?To eliminate varicose veins using this method, a long stay in the hospital is not required.The procedure is performed on an outpatient basis and does not require bed rest.You can return to your usual lifestyle and professional obligations the very next day.The only thing that will take time is rehabilitation.Recovery after EVLT of the veins can take a maximum of one and a half months.During this period, it is important to responsibly follow all the recommendations of the attending physician.
Daily routine after the procedure
The daily routine in the postoperative period requires regularity.A proper balance between wakefulness and sleep, activity and rest, as well as food intake, health measures, etc. To help the body recover and reduce the risk of relapse, it is necessary to make some lifestyle adjustments.The daily routine and routine must be brought closer to adhering to the rules of a healthy lifestyle.
What should you not do after the procedure?
After the procedure to remove varicose veins, there are certain contraindications and restrictions.First of all, you need to get rid of bad habits.Alcohol and smoking are prohibited after laser coagulation, at least for the rehabilitation period.The diet should also be balanced and appropriate to control weight.
For several weeks after EVLT, you should avoid hot baths and visits to baths, saunas and swimming pools.
Visiting tanning salons popular among the fairer sex and body care procedures in beauty salons are prohibited.Women also need to replace their high heels with more comfortable shoes with low, stable heels.
Exercise after the procedure
Fearing complications and relapses, some patients wonder whether exercise and running are allowed after EVLT?Let's start with the fact that after laser coagulation of veins and miniphlebectomy, you must immediately start exercising to reduce the risk of blood clots.From the next day after surgery, daily walking should last at least 1.5 to 2 hours.There is a peculiarity: in the first few days the patient has to wear compression stockings around the clock.In addition, wearing medical underwear is intended only during the day and for a period of up to six months, after which the doctor will determine the compression class of the knitwear during a follow-up examination.
Sport is allowed and even necessary!However, not all types are acceptable during the rehabilitation period.It is important to exclude significant physical activity such as weight lifting, strength training in gyms, etc.Is running possible after laser coagulation of veins?Experts prohibit fast running as a form of impact exercise.This also includes jumping and jerking.Such stress after an operation is extremely undesirable.
Complications after EVLT
Like any other surgery, laser coagulation of the veins of the lower extremities has potential complications.Adverse consequences of laser coagulation in the postoperative period are rare, sometimes even extremely rare (1:10,000).Therefore, the method is considered the most effective.However, one must be aware of the following complications after EVLT surgery:
- thrombophlebitis;
- deep vein thrombosis;
- pulmonary embolism;
- burns;
- paresthesia;
- Hyperthermia.
Is there normal pain after EVLT and how long does it last?What to do if the leg is pulled and swelling occurs?Which of the following can be considered a complication after EVLT?
Expert opinion
After coagulation, a large vein forms a dense cord with redness.As a rule, such thickening at the injection site and redness occur 7-10 days after endovascular laser photocoagulation (EVLC).This phenomenon is normal but temporary.In addition, it disappears quickly when applied locally.
Some patients note that their leg hurts and becomes numb in the first two days after laser coagulation of the veins.These unpleasant sensations are more likely to be due to the unusual wearing of medical knitwear than to the treatment procedure itself.Rarely, excruciating pain and tension in the vein bed occur.They last no more than a month and a half and disappear on their own. It should be noted that on the first day, in response to the coagulation of the proteins of the vascular wall, a temperature of no more than 38 ° C may occur.After EVLT, the doctor will inform the patient about all possible complications and give recommendations on what to do in each individual case.
Pregnancy after EVLT
EVLT of pregnancy veins cannot affect pregnancy in any way.On the contrary: When planning a pregnancy, solving the problem of varicose veins would be the absolutely right step.Therefore, the answer to the question of whether to perform laser coagulation or not is obvious.Because during pregnancy, the load on the vessels increases and the disease worsens by 100%.Pregnancy precludes surgical intervention.Only in difficult situations, when the situation is critical, can the attending physician prescribe a radical method of treating varicose veins to a pregnant woman.
If pregnancy occurs after EVLT, measures should be taken to prevent relapse.
For this purpose, wearing medical compression stockings, performing gymnastic exercises, self-massage of the limbs and using vein-strengthening creams are recommended.A foot cream with chestnut and ginkgo biloba extract is ideal during pregnancy due to its properties.Its composition is natural, which means that the product is safe for the health of the expectant mother and baby.