Unfortunately, vascular pathologies have a global status.People of different ages and sexes are susceptible to them.Various reasons can contribute to the development of varicose veins of the lower extremities, and there are many of them.Therefore, statistics on the registration of vascular diseases are inevitably 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 with the attending physician.Its choice 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 include conservative, surgical methods or their symbiosis in the treatment regimen at will.
Conservative methods include drug and non-drug treatment.These treatment methods can be the only ones in the initial stage of the disease, when the first symptoms 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.They all have indications and contraindications, as well as 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 a layperson to understand medical terms.Therefore, the question arises: what is it and why is it done?
EVLT of the veins of the lower extremities: preparation, procedure technique, indications and contraindications
What is EVLT treatment for varicose veins?Endovascular or endovenous laser coagulation (EVLC) of the veins of the lower extremities is a minimally invasive procedure for the elimination of varicose veins.
How is endovasal laser coagulation of varicose veins performed?This method has been used for about ten years, so the procedure has been improved to this day.EVLT is characterized as high-tech and rather complex manipulation, which requires high-quality equipment, especially high professional training of medical personnel.
This is a percutaneous intravascular surgical procedure.This means that laser coagulation of varicose veins in the legs involves inserting a peripheral catheter into the venous bed.A thin laser light guide is inserted through it 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 (low-concentration anesthetic mixture), the effect is expected to last 6-10 hours.Due 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 performed using duplex scanning.
Thus, the specialist controls the laser and its position in the vein.Laser treatment of varicose veins takes about 40 minutes, without taking into account the initial marking of the veins.If necessary, sclerotherapy or miniphlebectomy of large varicose branches of the great and small saphenous veins is performed the next day.This is due to the fact that endovasal laser coagulation places limits on the permissible expansion of the varicose branches of the great saphenous vein (GSV) and the small saphenous vein.For the procedure to be effective, the diameter of the vessels should be expanded to 25 mm.Therefore, if some veins appear after EVLT treatment, there is no need to worry.They can be removed by injecting sclerosants into the venous orifice or by puncturing, then removing the vein and physically removing it.As research results show, in such cases, there is a good clinical and lasting cosmetic effect without signs of relapse in the postoperative period.In addition, in general, social rehabilitation of patients is accelerated (if medical recommendations are followed immediately after surgery).
Laser coagulation of blood vessels in the legs: preparatory stage
What is preparation for coagulation?Preparation is not difficult.To perform endovascular laser coagulation of the veins of the lower extremities, the following are required:
- general examination of the patient's health (general clinical blood and urine tests, 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.
Medical compression stockings must be prepared in advance.
You will need it immediately after laser varicose vein treatment (EVLT).As a rule, the doctor prescribes compression class II knitwear for this purpose.
EVLT of the veins of the lower extremities: indications and contraindications
If laser coagulation of blood vessels in the legs is prescribed, then there are few indications: the presence of varicose veins (starting from the 2nd stage according to CEAP), trophic disorders of the lower leg, flat veins.
Removing veins in this way also has a number of contraindications:
- excess body weight (obesity);
- vascular diseases of the lower extremities accompanied by the formation of atherosclerotic plaques on the inner walls of blood vessels;
- diseases of the musculoskeletal system, stroke, etc.due to limited movement of the patient;
- infectious diseases;
- inflammatory processes of the skin and subcutaneous tissue;
- hypertension in the acute stage;
- some chronic diseases in the acute phase.
Is it possible to do EVLT if there are blood clots?A condition 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.
During pregnancy and for how long is laser venous coagulation allowed?
Expert opinion
EVLT surgery is prohibited during pregnancy and after childbirth, during lactation.Non-drug methods of conservative therapy 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 veins of the lower extremities
Those who are prescribed EVLT (laser subcutaneous coagulation) of the veins of the lower extremities are wondering if it is necessary to open a sick leave card?To eliminate varicose veins using 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 normal lifestyle and work commitments the next day.The only thing that will take time is rehabilitation.Vascular recovery after EVLT can take a maximum of one and a half months.During this period, it is important to responsibly follow all the recommendations received from the attending physician.
Daily routine after the procedure
In the postoperative period, the daily routine requires regularity.Wakefulness and sleep, activity and rest, as well as food intake, health procedures, etc.the right balance betweenIt is necessary to make some lifestyle adjustments to help the body recover and reduce the risk of relapse.The daily routine and routine should be adjusted to some extent to fit the rules of a healthy lifestyle.
What should you not do after the procedure?
There are certain contraindications and restrictions after the procedure to remove varicose veins.First of all, you need to get rid of bad habits.After laser coagulation, alcohol and smoking are prohibited, at least for the rehabilitation period.Nutrition should also be balanced and correct to control weight.
For several weeks after EVLT, you should avoid taking a hot bath, as well as visiting baths, saunas, and swimming pools.
Body care procedures are prohibited in tanning salons and beauty salons, which are popular with the fairer sex.Women will also need to swap their high heels for more comfortable shoes with low, stable heels.
Exercise after the procedure
Fearing complications and relapse, some patients think they are allowed to exercise and run after EVLT?Let's start with the fact that after laser vascular coagulation and miniphlebectomy, you should start moving immediately, which will reduce the risk of blood clots.Starting from the day after surgery, daily walking should take at least 1.5-2 hours.There is one feature - in the first days, the patient must stay in compression stockings day and night.In addition, the wearing of medical underwear is provided only during the day and for up to six months, then the doctor will select the compression class of the knitwear during the re-examination.
Sports are allowed and even necessary!But not all types of it are acceptable during the rehabilitation period.Weight lifting, strength training in gyms, etc.It is important to exclude significant physical activity.Is it possible to escape after laser coagulation of veins?Experts prohibit sprinting as a form of shock loading.These include jumping and leaping.Such loads are extremely undesirable after surgery.
Complications after EVLT
Like any other operation, laser coagulation of the veins of the lower extremities has potential complications.Undesirable consequences 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 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 to do if your leg is pulled and swollen?Which of the following would be considered a complication after EVLT?
Expert opinion
After coagulation, a large vein forms a dense cord with redness.As a rule, such compression and redness at the puncture site occur 7-10 days after endovasal laser coagulation (EVLC).This phenomenon is normal but temporary.In addition, it quickly reverses when applied topically.
Some patients report pain and numbness in their legs during the first two days after laser coagulation.These unpleasant sensations are associated more with the unusual wearing of medical knitwear than with the treatment procedure itself.In rare cases, there are nagging pains and tension along the venous bed.They last no more than a month and a half and go away by themselves.It should be noted that on the first day, in response to the coagulation of the proteins of the vessel wall, a temperature not higher than 38 ° C may occur.After EVLT, the doctor will inform the patient about all possible complications and give recommendations on how to behave in a certain situation.
Pregnancy after EVLT
EVLT of pregnancy vessels cannot interfere with pregnancy in any way.On the contrary, when planning pregnancy, solving the problem of varicose veins would be absolutely the right step.Therefore, the answer to the question of laser coagulation or not is clear.Because during pregnancy, the load on the vessels will increase and the disease will worsen 100%.Pregnancy excludes surgical intervention.Only in difficult situations, when the situation is critical, the attending physician can prescribe a radical method to treat varicose veins to a pregnant woman.
If pregnancy occurs after EVLT, measures should be taken to prevent recurrence.
For this purpose, it is recommended to wear compression medical stockings, perform gymnastic exercises, self-massage of the extremities and apply vein-tonic creams.Foot cream with extracts of chestnut and ginkgo biloba is ideal during pregnancy due to its properties.Its composition is natural, which means that the product is safe for the health of the future mother and baby.