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 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 is up to the attending physician.Its selection is determined by the stage at which vascular pathology is detected, the dynamics of the disease, the patient's general health status and other factors.At his discretion, the specialist may 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 the 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.They all 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 for?
EVLT of lower limb veins: preparation, procedure technique, 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 for eliminating varicose veins.
How is endovasal laser coagulation of varicose veins performed?This method has been practiced for about ten years, which is why 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 mainly 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 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, thermal burns occur and subsequent adhesion of the venous wall with obliteration of the light.The procedure will be carried out under local anesthesia (a low-concentrate mixture of anesthetics), with an expected duration of effect of 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 hematoma formation after EVLT.
All EVLT steps are performed 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 varicose vein treatment takes about 40 minutes.If necessary, the following day, sclerotherapy or miniphlebectomy of the large tributary varicose veins of the great and small saphenous veins is performed.This is because endovasal laser coagulation has limitations in the allowable expansion of varicose tributaries of the great saphenous vein (GSV) and small saphenous vein.For the procedure to be effective, the veins must expand 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 by performing a puncture, removing the vein and physically removing it.As the research results show, in these cases, in the postoperative period, there is a good clinical and long-lasting cosmetic effect, without signs of recurrence.In addition, in general, the social rehabilitation of patients is accelerated (if medical recommendations begin to be followed immediately after surgery).
Laser coagulation of blood vessels in the legs: preparatory phase
What is the preparation for coagulation?Preparation is not difficult.For endovascular laser coagulation of the veins of the lower limb to be performed, it is necessary:
- general screening of the patient's health status (general clinical blood and urine tests, blood test for SR, 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);
- therapist's conclusion about the absence of contraindications.
It is necessary to prepare medical compression stockings in advance.
You will need it immediately after laser varicose vein treatment (EVLT).As a rule, the doctor prescribes class II compression garments 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, there are few indications: presence of varicose veins (from CEAP stage 2), trophic disorders of the 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 phase;
- some chronic diseases in the acute phase.
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 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 (subcutaneous laser 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 normal 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 post-operative routine requires regularity.An adequate balance between wakefulness and sleep, activity and rest, as well as dietary intake, health procedures, etc.To help your body recover and reduce the risk of relapse, you need to make some lifestyle adjustments.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 varicose vein removal procedure.First of all, you need to get rid of bad habits.Alcohol and smoking after laser coagulation are prohibited, at least during the rehabilitation period.The diet 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, which are popular with the fair sex, and body care procedures in beauty salons are prohibited.Women will also have to swap high heels for more comfortable shoes with low, stable heels.
Exercise after the procedure
Fearing complications and relapse, some patients wonder if playing sports and running are allowed after EVLT.Let's start with the fact that after laser vein coagulation and miniphlebectomy, you should immediately start moving, this will reduce the risk of blood clots.From the next day after surgery, daily walking should last at least 1.5 to 2 hours.There is a peculiarity - in the first few days the patient must wear compression stockings 24 hours a day.In addition, the use of medical underwear is provided only during the day and for a period of up to six months, so 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 activities such as weight lifting, strength training in gyms, etc.Is it possible to run after laser vein coagulation?Experts prohibit fast running as a form of shock loads.This also includes jumping and shaking.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 postoperative laser coagulation are uncommon and some are even extremely rare (1:10,000).Therefore, the method is considered 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 considered a complication after EVLT?
Expert opinion
A large vein after clotting forms a dense cord with redness.As a rule, this puncture site compaction and redness occur 7 to 10 days after endovasal laser coagulation (EVLC).This phenomenon is normal, but it is temporary.Furthermore, it regresses quickly when applied locally.
Some patients notice that their legs hurt and feel numb during the first two days after laser vein coagulation.These unpleasant sensations are more likely associated with the unusual use of medical mesh than with the treatment procedure itself.There are rarely dull 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 mentioning that on the first day, in response to the coagulation of proteins in the vessel wall, a temperature not exceeding 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 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 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 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 for a pregnant woman.
When pregnancy occurs after EVLT, measures should be taken to prevent relapse.
To this end, it is recommended to use medical compression stockings, perform gymnastics exercises, self-massage the limbs 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 pregnant woman and her baby.