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 in the lower extremities, and there are quite a few.Therefore, statistics on the registration of vascular diseases are growing 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 therapeutic regimen remains in the hands of the treating physician.Its selection is determined by the stage at which 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 may include conservative surgical methods or their symbiosis in the treatment regimen.
Conservative methods include pharmacological and non-pharmacological therapy.These treatment methods may be the only ones at the initial stage of the disease, when its first signs appear, and in 100% of cases they are a complement to surgical methods.
Expert opinion
Surgical methods are used for 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 why is it done?
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 lower extremity veins (EVLC) is a minimally invasive process to remove 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 improved to this day.EVLT is characterized as a high-tech and quite complex manipulation that requires not only high-quality equipment, but also 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 fine laser light guide penetrates to cauterize the veins.Under its influence, a thermal burn occurs and the subsequent adhesion of the venous wall with obliteration of the lumen.The procedure will be performed under local anesthesia (a mixture of low-concentration anesthetics) and its effect is expected to last 6 to 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 bruising after EVLT.
All stages of EVLT are carried out using duplex scanning.
Thus, the specialist controls the laser and its position in the vein.Without taking into account the preliminary marking of the veins, laser treatment of varicose veins lasts about 40 minutes.If necessary, sclerotherapy or miniphlebectomy of large varicose tributaries of the great and small saphenous veins is performed the next day.This occurs because endovasal laser coagulation has limitations in 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 nothing to worry about.They can be removed by introducing sclerosants into the venous mouth or by performing a puncture, then removing the vein and physically removing it.As the research results show, in such cases, a good long-lasting clinical and cosmetic effect is observed in the postoperative period, without signs of relapse.In addition, patients' social rehabilitation is generally accelerated (if medical recommendations begin to be followed immediately after surgery).
Laser coagulation of blood vessels in the legs: preparatory stage.
What is the preparation for coagulation?The preparation is not difficult.In order to perform endovascular laser coagulation of the veins of the lower limb, the following is required:
- general examination of the patient's health status (general clinical blood and urine tests, blood test for RW, comprehensive analysis of blood coagulation indicators, blood test 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 varicose vein laser treatment (EVLT).As a rule, the doctor prescribes class II compression knitwear for this purpose.
EVLT of the veins of the lower extremities: 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:
- excess body 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 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 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 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
EVLT surgery is prohibited during pregnancy and after childbirth, during breastfeeding.Non-drug conservative methods of therapy are recommended for pregnant and lactating women, because... it is necessary to exclude all possible risks to the intrauterine development and health of the already born child.
Rehabilitation after laser coagulation of the veins of the lower extremities.
Those who are prescribed EVLT (subcutaneous laser coagulation) of the veins of the lower extremities wonder whether it is necessary to open a sick leave certificate.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 regular 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 a month and a half.During this period of time, it is important to responsibly follow all recommendations received from the treating doctor.
Daily routine after the procedure.
The daily routine in the postoperative period requires regularity.An adequate 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, some lifestyle adjustments are necessary.It will be necessary to bring the routine and daily routine to a certain extent closer to compliance with 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.It is prohibited to drink alcohol and smoke after laser coagulation, at least during the rehabilitation period.Nutrition must also be balanced and adequate 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, loved by the fair sex, and body care procedures in beauty salons are prohibited.Women will also have to change their high heels for more comfortable shoes with low, stable heels.
Exercise after the procedure.
Fearing complications and relapses, some patients wonder whether sports and running are allowed after EVLT.Let's start with the fact that after laser coagulation of veins and mini-phlebectomy, you should immediately start moving, this will reduce the risk of blood clots.Starting the day after surgery, your daily walk should last at least 1.5 to 2 hours.There is a peculiarity: during the first days, the patient must remain in compression stockings 24 hours a day.In addition, the use of medical underwear is allowed 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 new examination.
Sports are 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 vein coagulation?Experts prohibit fast running as a form of shock loads.These also include jumping and jerking.These types of loads after surgery are extremely undesirable.
Complications after EVLT
Like any other operation, laser coagulation of the veins of the lower extremities has possible 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, the following complications after EVLT surgery need to be taken into account:
- 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 occurs?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 compaction at the puncture site and redness occurs 7-10 days after endovasal laser coagulation (EVLC).This phenomenon is normal, but it is temporary.Additionally, it recedes quickly when applied locally.
Some patients notice that their leg hurts and feels numb for the first two days after laser vein coagulation.These unpleasant sensations are more likely to be associated with the unusual use of medical knitwear than with the treatment procedure itself.Rarely, there are persistent pains and tension along the venous bed.They don't last more than a month and a half and disappear on their own.It is worth noting that on the first day, in response to coagulation of proteins of the vessel wall, a temperature 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 particular case.
Pregnancy after EVLT
EVLT from pregnancy veins cannot interfere with 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 or not to perform 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, the attending physician can prescribe a radical method of treating varicose veins to a pregnant woman.
When pregnancy occurs after EVLT, measures should be taken to prevent relapse.
To achieve this, it is recommended to use medical compression stockings, perform gymnastic exercises, self-massage of the extremities and apply venous 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.