Unfortunately, vascular pathologies have a global status.People of different ages and genders are susceptible to them.Various reasons can contribute to the appearance of varicose veins of the lower extremities, and there are many of them.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 with the attending physician.Its choice is determined by the stage at which the vascular pathology was detected, the dynamics of the disease, the patient's general state of health 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 can be the only ones in the initial phase 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 advantages and disadvantages.
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 vein 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 procedure for the elimination of varicose veins.
How is endovasal laser coagulation of varicose veins performed?This method has been practiced for ten years, so the procedure has been improved until today.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 that cauterizes the veins.Under its influence, there is a thermal burn and subsequent adhesion of the vein wall with obliteration of the lumen.The procedure will be performed under local anesthesia (a low-concentration anesthetic mixture), and the effect is expected to last 6-10 hours.Thanks to the addition of a vasoconstrictor 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 using duplex scanning.
Thus, the expert 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 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 allowed 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 dilated 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 a sclerosant into the vein mouth or by a puncture, then pulling out the vein and physically removing it.As research results show, in such cases, in the postoperative period, there is a good clinical and permanent cosmetic effect, without signs of relapse.In addition, social rehabilitation of patients is generally accelerated (if medical recommendations are followed immediately after surgery).
Laser coagulation of blood vessels on the legs: preparatory phase
What is coagulation preparation?Preparation is not difficult.In order to perform endovascular laser coagulation of the veins of the lower extremity, the following is required:
- general screening of the patient's health condition (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 of the therapist on the absence of contraindications.
It is necessary to prepare medical compression stockings in advance.
You will need it right after laser varicose vein treatment (EVLT).As a rule, for this purpose, the doctor prescribes a class II compression garment.
EVLT vein 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 the 2nd stage according to CEAP), trophic disorders of the lower leg, flat veins.
Removing veins in this way 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 phase;
- some chronic diseases in the acute phase.
Is it possible to perform EVLT if there are blood clots?A prerequisite for surgery 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 during pregnancy and after childbirth, during lactation, is prohibited.Non-medicinal 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 have been prescribed EVLT (laser subcutaneous coagulation) of the veins of the lower extremities wonder if it is necessary to open a sick leave?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.Appropriate balance between wakefulness and sleep, activity and rest, as well as food intake, health procedures, etc.In order for the body to recover and reduce the risk of relapse, it is necessary to make some adjustments in the way of life.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 not be done after the procedure?
There are certain contraindications and restrictions after the procedure to remove varicose veins.First of all, you have 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, hot baths, as well as visits to baths, saunas and swimming pools, should be avoided.
Solariums, favored by the fairer sex, and body care procedures in beauty salons are prohibited.Women will also need to change their high heels to more comfortable shoes with low, stable heels.
Exercise after the procedure
Fearing complications and recurrence, 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 need to start moving immediately, this will reduce the risk of blood clots.Starting from the next day after surgery, daily walking should last at least 1.5-2 hours.There is one peculiarity - during the first days the patient must stay in compression stockings for 24 hours.Furthermore, the wearing of medical underwear is allowed only during the day and for up to six months, and then the doctor will choose the compression class of knitwear at the 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 activities, such as lifting weights, strength training in the gym, etc.Is it possible to run after laser vein coagulation?Experts forbid fast running as a form of impact loading.It also includes jumping and twitching.Such loads after surgery are extremely undesirable.
Complications after EVLT
Like any other surgery, laser coagulation of the veins of the lower extremities has potential complications.Side effects of laser coagulation in the postoperative period are rare, and some are even extremely rare (1:10,000).Therefore, this method is 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 to do if your leg pulls and swelling appears?Which of the following can be considered complications after EVLT?
Expert opinion
A large vein forms a thick cord with redness after coagulation.As a rule, such compaction at the injection site and redness occurs 7-10 days after endovasal laser coagulation (EVLC).This phenomenon is normal, but it is temporary.Additionally, it resolves quickly when applied topically.
Some patients notice that their leg hurts and goes numb for the first two days after laser vein coagulation.These unpleasant sensations are more likely to be related to the unusual wearing of medical hosiery than to the treatment itself.Rarely, nagging pains and tension along the venous bed occur.They last no more than a month and a half and disappear on their own.It is worth noting that on the first day, in response to the coagulation of the vessel wall proteins, a temperature of no 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 specific case.
Pregnancy after EVLT
EVLT pregnancy vein 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.So, to the question of whether to do laser coagulation or not, the answer is obvious.Because during pregnancy, the load on blood vessels will increase, and the disease will worsen by 100%.Pregnancy excludes surgical intervention.Only in difficult situations, when the situation is critical, the doctor can prescribe a radical method of treating varicose veins.
When 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 the limbs and apply creams to strengthen the veins.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.