Unfortunately, vascular pathologies have a global status.People of different ages and genders are susceptible to them.Various reasons can contribute to the development of varicose veins of the lower extremities, and there are quite a few of them.Therefore, the statistics of registering vascular diseases is inexorably increasing.At the same time, science and medicine do not stand still, and the number of treatment methods already represents an impressive list.
The choice of therapeutic regimen remains for the attending physician.Its choice is determined by the stage at which the vascular pathology is detected, the dynamics of the disease, the general state of health of the patient and other factors.At his discretion, the specialist can include in the treatment scheme conservative, surgical methods or their symbiosis.
Conservative methods include drug and non-drug therapy.These methods of treatment can be the only ones in the initial stage of the disease, when its first signs appear, and in 100% of cases they are an addition to surgical methods.
Expert opinion
Surgical methods are used in advanced forms of vascular pathology.Surgical methods are divided into invasive and minimally invasive.All of them have indications and contraindications, as well as their pros and cons.
One of the most popular modern therapeutic 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, technique of the procedure, 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 process to eliminate varicose veins.
How is endovasal laser coagulation of varicose veins performed?This method has been practiced for about ten years, so the procedure has been perfected to this day.EVLT is characterized as a high-tech and rather complex manipulation that requires not only high-quality equipment, but also particularly high professional training of the medical staff.
This is a percutaneous intravascular surgical procedure.This means that laser coagulation of varicose veins of the legs involves the introduction of a peripheral catheter into the venous bed.Through which a thin laser light wire penetrates to burn the veins.Under its influence, a thermal burn occurs and subsequent adhesion of the venous wall with obliteration of the lumen.The procedure will be performed under local anesthesia (a low-concentration mixture of anesthetics), its effect is expected to last 6-10 hours.Thanks to the addition of vasoconstrictors to the mixture, in addition to the anesthetic effect, a vasoconstrictor is also achieved.This reduces the risk of hematoma formation after EVLT.
All stages of EVLT are performed by duplex scanning.
Thus, the specialist controls the laser and its position in the vein.Without taking into account the previous marking of the veins, the laser treatment of varicose veins takes about 40 minutes.If necessary, sclerotherapy or miniphlebectomy of large dilated tributaries of the great and small saphenous veins is performed the next day.This occurs because endovasal laser coagulation has limitations on the allowable dilation of the varicose tributaries of the great saphenous vein (GSV) and the small saphenous vein.For the procedure to be effective, the veins must have dilated up to 25 mm in diameter.Therefore, if after EVLT treatment some veins remain visible, there is no need for concern.They can be eliminated by introducing sclerosants into the venous orifice or by puncture, after which the vein is brought out and physically removed.As the research results show, in such cases, in the postoperative period, there is a good clinical and lasting cosmetic effect, without signs of recurrence.In addition, in general, the social rehabilitation of patients is accelerated (if medical recommendations are followed immediately after the operation).
Laser coagulation of blood vessels of the legs: preparatory stage
What is the preparation for coagulation?Preparation is not difficult.In order to perform endovascular laser coagulation of the veins of a lower limb, it is necessary:
- general screening of the patient's state of health (general clinical examinations of blood and urine, blood test for RW, comprehensive analysis of blood coagulation indicators, blood tests for viral hepatitis B and C, AIDS, HIV and syphilis);
- examination of veins and blood vessels (USDS);
- conclusion from the therapist 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, for this purpose, the doctor prescribes hosiery of the II compression class.
EVLT of lower extremity veins: indications and contraindications
If laser coagulation of the blood vessels of the legs is prescribed, then the indications are few: the presence of varicose veins (starting from stage 2 according to CEAP), trophic disorders of the lower leg, straight veins.
Removing veins in this way 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;
- hypertension in the acute stage;
- some chronic diseases in an acute stage.
Is it possible to do EVLT if there are blood clots?A prerequisite for the operation is the absence of blood clots in the upper segment of the trunk of the saphenous vein.Therefore, the presence of blood clots is also a contraindication.
Is laser venous coagulation allowed during pregnancy and until when?
Expert opinion
Operation of EVLT during pregnancy and after childbirth, while breastfeeding is prohibited.Non-medicinal methods of conservative therapy are recommended for pregnant and lactating women, as... it is necessary to exclude all possible risks for intrauterine development and the health of the already born child.
Rehabilitation after laser coagulation of the veins of the lower extremities
Those who have been prescribed EVLT (laser subcutaneous coagulation) of the veins of the lower extremities, wonder if it is necessary to open a sick card?To remove varicose veins using this method, you do not need to stay in the hospital for a long time.The procedure is performed on an outpatient basis and does not require bed rest.You can return to your normal lifestyle and work duties 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 of time, it is important to responsibly follow all recommendations received from the attending physician.
Daily regime after the procedure
The daily regime in the postoperative period requires regularity.Correct balance between wakefulness and sleep, activity and rest, as well as food intake, health procedures, etc.To help the body recover and reduce the risk of relapse, it is necessary to make some lifestyle adjustments.Everyday life and routine will have to come to some extent to comply with 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 after laser coagulation are prohibited, at least during the rehabilitation period.Nutrition should also be balanced and suitable for weight control.
For several weeks after EVLT, you should avoid taking hot baths, as well as visiting baths, saunas and swimming pools.
Favorites of the fairer sex, solariums and body care procedures in beauty salons are prohibited.Women will also need to change their high shoes to more comfortable ones with low, stable heels.
Exercise after the procedure
Fearing complications and relapse, some patients wonder if sports and running are allowed after EVLT?Let's start with the fact that after laser vein coagulation and miniphlebectomy, you should immediately start moving, this will reduce the risk of blood clots.Starting from the next day after surgery, daily walking should take at least 1.5-2 hours.There is one feature - during the first days, the patient must be in compression stockings around the clock.In addition, the wearing of medical underwear is provided only during the day and for a period of up to six months, after which the doctor will choose the compression class of hosiery during a re-examination.
Sport is allowed and even necessary!But not all its types are acceptable during the rehabilitation period.It is important to exclude significant physical activity, such as lifting weights, strength training in gyms, etc.Is it possible to run after laser coagulation of veins?Experts forbid fast running as a form of impact loading.They also include jumping and pulling.Such loads after the operation are extremely undesirable.
Complications after EVLT
Like any other surgery, laser coagulation of the veins of the lower extremities has potential complications.Adverse effects of laser coagulation in the postoperative period are rare, and some are even extremely rare (1:10,000).Therefore, the method is considered the most effective.However, you need to 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 your leg is pulled and swelling appears?Which of the following can be considered a complication after EVLT?
Expert opinion
A large vein after coagulation forms a dense cord with redness.As a rule, such densification at the puncture site and redness appears 7-10 days after endovasal laser coagulation (EVLC).This phenomenon is normal, but it is temporary.In addition, it quickly regresses when applied topically.
Some patients note that their leg hurts and tingles in the first two days after laser vein coagulation.These unpleasant sensations are more related to the unusual wearing of medical hosiery than to the treatment procedure itself.Painful pains and tension along the venous channel rarely occur.They last no more than a month and a half and pass on their own.It is worth noting that on the first day, in response to the coagulation of the proteins of the vessel wall, a temperature of no higher than 38 ° C may appear. After EVLT, the doctor will inform the patient about all possible complications and give recommendations on how to behave in a specific case.
Pregnancy after EVLT
EVLT of pregnancy veins cannot prevent pregnancy in any way.On the contrary, when planning a pregnancy, the absolutely correct step would be to solve the problem of varicose veins.Therefore, to the question of whether to do laser coagulation or not, the answer is obvious.Because during pregnancy, the load on the vessels will increase and the disease will worsen by 100%.Pregnancy excludes surgical intervention.Only in difficult situations, when the situation is critical, the attending physician can prescribe a radical method for treating varicose veins of a pregnant woman.
When pregnancy occurs after EVLT, measures should be taken to prevent recurrence.
For this purpose, it is recommended to wear compression medical hosiery, perform gymnastic exercises, self-massage the limbs and apply venotonic creams.Foot cream with chestnut and ginkgo biloba extracts is ideal with its properties during pregnancy.Its composition is natural, which means that the product is safe for the health of the expectant mother and the baby.