Unfortunately, vascular pathologies have a global status.People of different ages and genders are susceptible to it.Various reasons can contribute to the development of varicose veins of the lower extremities, and there are many of them.Therefore, the statistics on the registration of vascular diseases are increasing inexorably.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 treatment regimen is up 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.At his discretion, the specialist can include conservative surgical methods or their symbiosis in the treatment regimen.
Conservative methods include drug and non-drug treatment.These methods of treatment can be the only ones at 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 for advanced forms of vascular pathology.Surgical methods are divided into invasive and minimally invasive methods.All of them have indications and contraindications, as well as their advantages and disadvantages.
One of the most popular modern therapeutic methods is the EVLT (endovasal laser coagulation) procedure 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 limbs: preparation, operative technique, indications and contraindications
What is EVLT treatment for varicose veins?Endovascular or endovenous laser coagulation of lower limb veins (EVLC) is a minimally invasive procedure for eliminating varicose veins.
How is endovasal laser coagulation of varicose veins carried out?This method has been practiced for around ten years, so the procedure has been improved to date.EVLT is characterized as a high-tech and rather complex manipulation that 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 laser coagulation of varicose veins of the legs involves the introduction of a peripheral catheter into the venous bed.Through which a thin guide of laser light penetrates 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 will be carried out under local anesthesia (a weakly concentrated mixture of anesthetics), its effect should last 6 to 10 hours.Thanks to the addition of vasoconstrictors to the mixture, in addition to the anesthetic effect, a vasoconstrictor is also obtained.This reduces the risk of hematoma formation after EVLT.
All stages of EVLT are carried out by double-sided scanning.
Thus, the specialist controls the laser and its position in the vein.Without taking into account the preliminary marking of the veins, the laser treatment of varicose veins lasts approximately 40 minutes.If necessary, the next day, sclerotherapy or miniphlebectomy of the large varicose tributaries of the large and small saphenous veins is performed.This occurs because endovasal laser coagulation has limitations on the allowable expansion 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 an expansion of up to 25 mm in diameter.Therefore, if after EVLT treatment some veins remain visible, there is no need to worry.They can be removed by introducing sclerosants into the venous mouth or by performing a puncture, then popping out the vein and physically removing it.As research results show, in such cases, in the postoperative period, a good clinical and long-lasting cosmetic effect is observed, without signs of relapse.In addition, in general, the social reintegration of patients is accelerated (if medical recommendations begin to be followed immediately after surgical intervention).
Laser coagulation of blood vessels in the legs: preparatory stage
What is the preparation for coagulation?The preparation is not difficult.To perform endovascular laser coagulation of the veins of the lower limb, you must:
- general screening of the patient's health status (general clinical tests 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);
- therapist's conclusion on the absence of contraindications.
It is necessary to prepare medical support stockings in advance.
You will need it immediately after varicose vein laser treatment (EVLT).As a rule, the doctor prescribes compression class II knitwear for this purpose.
EVLT of lower limb veins: indications and contraindications
If laser coagulation of the blood vessels of the legs is prescribed, then the indications are few: presence of varicose veins (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:
- excess weight (obesity);
- diseases of the arteries of the lower extremities, accompanied by the formation of atherosclerotic plaques on the inner walls of blood vessels;
- limited movements of the patient due to diseases of the musculoskeletal system, strokes, etc. ;
- infectious diseases;
- inflammatory processes of the skin and subcutaneous tissue;
- hypertension in the acute stage;
- certain chronic diseases in the 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 saphenous vein trunk.Therefore, the presence of blood clots is also a contraindication.
Is laser venous coagulation permitted during pregnancy and for how long?
Expert opinion
EVLT surgery during pregnancy and after childbirth, while breastfeeding, is prohibited.Non-drug methods of conservative treatment are recommended for pregnant and lactating women, because... 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 limbs
Those who are prescribed EVLT (subcutaneous laser coagulation) of the veins of the lower extremities are wondering whether it is necessary to open a sick leave?To eliminate varicose veins with this method, it is not necessary 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 usual lifestyle and work responsibilities the 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 recommendations received from the attending physician.
Daily routine after the procedure
The daily routine in the postoperative period requires regularity.A good balance between wakefulness and sleep, activity and rest, as well as food intake, health actions, etc.To help the body recover and reduce the risk of relapse, it is necessary to make some lifestyle adjustments.Daily routine and routine will have to be brought closer to a certain extent with compliance with the rules of a healthy lifestyle.
What should you not do after the procedure?
There are certain contraindications and restrictions after the varicose vein removal procedure.First of all, you need to get rid of bad habits.Alcohol and tobacco after laser coagulation are prohibited, at least during the rehabilitation period.Nutrition should also be balanced and appropriate to control weight.
For several weeks after EVLT, you should avoid taking hot baths, as well as visiting baths, saunas and swimming pools.
Tanning salons, popular with the fair sex, and body treatments in beauty salons are prohibited.Women will also need to replace their high heels with more comfortable shoes with low, stable heels.
Exercising after the procedure
Fearing complications and relapses, some patients wonder if sports and running are allowed after EVLT?Let's start with the fact that after laser coagulation of veins and miniphlebectomy, you should immediately start moving, this will reduce the risk of blood clots.Starting the day after surgery, daily walking should take at least 1.5 to 2 hours.There is a peculiarity: during the first days, the patient must remain in compression stockings around the clock. In addition, wearing medical underwear is planned only during the day and for a period of up to six months, then the doctor will select the compression class of the knitwear during a re-examination.
Sport is allowed and even necessary!But not all of its types are acceptable during the rehabilitation period.It is important to exclude any significant physical activity, such as lifting weights, strength training in gyms, etc.Is it possible to run after laser coagulation of veins?Experts prohibit fast running as a form of shock loading.These also include jumping and jerking.Such loads after surgery are extremely undesirable.
Complications after EVLT
Like any other operation, laser coagulation of lower limb veins has potential complications.Undesirable consequences of laser coagulation in the postoperative period are rare, even extremely rare (1: 10,000).This method is therefore considered the most effective.However, one should 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 should you 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.Typically, such compaction at the puncture site and redness occurs 7-10 days after endovasal laser coagulation (EVLC).This phenomenon is normal, but temporary.In addition, it regresses quickly when applied topically.
Some patients notice that their leg hurts and becomes numb for the first two days after laser vein clotting.These unpleasant sensations are more likely associated with the unusual wearing of medical knitwear than with the treatment procedure itself.There is rarely nagging pain and tension along the venous bed.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 proteins of the vascular wall, a temperature not exceeding 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 particular case.
Pregnancy after EVLT
EVLT of pregnancy veins cannot interfere with pregnancy in any way.On the contrary, when planning a pregnancy, the most appropriate solution would be to solve the problem of varicose veins.Therefore, to the question of whether or not to do laser coagulation, 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, can the attending physician prescribe a radical method of treating varicose veins to a pregnant woman.
In case of pregnancy after EVLT, measures should be taken to prevent relapse.
For this purpose, it is recommended to wear medical compression stockings, perform gymnastic exercises, self-massage the limbs and apply veno-tonic creams.A foot cream with chestnut and ginkgo biloba extracts is ideal for its properties during pregnancy.Its composition is natural, which means that the product is safe for the health of the future mother and baby.