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 lot of them.Therefore, statistics on the registration of vascular diseases are inexorably growing.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 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 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 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.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 done for?
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 of the veins of the lower extremities (EVLC) is a minimally invasive process for eliminating 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 rather complex manipulation that requires not only high-quality equipment, but especially high professional training of medical personnel.
This is a percutaneous intravascular surgical procedure.This means that laser coagulation of varicose veins on the legs involves the introduction of a peripheral catheter into the venous bed.Through which a thin laser light guide penetrates to cauterize 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-concentrated 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 carried out using duplex scanning.
Thus, the specialist controls the laser and its position in the vein.Without taking into account preliminary marking of veins, laser treatment of varicose veins takes about 40 minutes.If necessary, the next day, sclerotherapy or miniphlebectomy of large varicose tributaries of the great and small saphenous veins is performed.This occurs because endovasal laser coagulation has limitations on the permissible expansion of varicose tributaries of the great saphenous vein (GSV) and the small saphenous vein.In order 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 eliminated by introducing sclerosants into the venous mouth or making a puncture, then bringing the vein out and physically removing it.As research results show, in such cases, in the postoperative period, there is a good clinical and lasting cosmetic effect, without signs of relapse.In addition, in general, social rehabilitation of patients is accelerated (if medical recommendations begin to be followed immediately after surgery).
Laser coagulation of blood vessels on the legs: preparatory stage
What is the preparation for coagulation?The preparation is not difficult.In order for endovascular laser coagulation of the veins of the lower limb to be performed, the following is required:
- general screening 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);
- 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 treatment of varicose veins (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 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 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 surgery during pregnancy and after childbirth, during lactation, is prohibited.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 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, 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 very next day.The only thing that will take time is rehabilitation.Recovery after EVLT of 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 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 procedures, etc. To help the body recover and reduce the risk of relapse, it is necessary to make some adjustments to the lifestyle.The daily routine and routine will need to be brought closer to some extent 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.Alcohol and smoking after laser coagulation are prohibited, at least for the rehabilitation period.Nutrition should also be balanced and proper 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, beloved by the fair sex, and body care procedures in beauty salons are prohibited.Women will also have to change their high heels to more comfortable shoes with low, stable heels.
Exercising after the procedure
Fearing complications and relapse, some patients wonder whether sports and running are allowed after EVLT?Let's start with the fact that after laser coagulation of veins and miniphlebectomy, you must 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 peculiarity - during the first days, the patient must remain in compression stockings around the clock.Further, the wearing of medical underwear is provided only during the daytime and for a period of up to six months, then the doctor will select the compression class of the knitwear during a re-examination.
Sports are allowed and even necessary!But not all of 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 prohibit fast running as a form of shock loads.These also include jumping and jerking.Such loads after surgery are extremely undesirable.
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 uncommon, and some are even extremely rare (1:10,000).Therefore, the method is considered to be the most effective.However, it is necessary 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 occurs?Which of the following can be regarded as 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 is temporary.In addition, it quickly regresses when applied locally.
Some patients note that their leg hurts and goes numb during the first two days after laser coagulation of veins.These unpleasant sensations are more likely associated with the unusual wearing of medical knitwear than with the treatment procedure itself.Rarely there are nagging pains and tension along the venous bed.They last no more than a month and a half and go away on their own.It is worth noting that on the first day, in response to coagulation of the proteins of the vessel wall, a temperature may occur, not higher than 38°C.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 the veins of pregnancy cannot in any way interfere with pregnancy.On the contrary, when planning a pregnancy, the absolutely right 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 100% worsen.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.
When pregnancy occurs after EVLT, measures should be taken to prevent relapse.
For this purpose, wearing compression medical hosiery, performing gymnastic exercises, self-massage of the limbs and applying vein-tonic creams are recommended.A foot cream with chestnut and ginkgo biloba extracts is ideal for its properties during pregnancy.Its composition is natural, which means the product is safe for the health of the expectant mother and baby.