Unfortunately, vascular pathology has a global status.People of all ages and genders are susceptible to their effects.There are many causes of varicose veins in the lower limbs, and there are quite a few types.Therefore, the statistics of vascular disease registries are constantly growing.Meanwhile, science and medicine are not standing still, and the number of treatments is already impressive.
The choice of treatment depends on the treating physician.The choice depends on the stage of vascular pathology testing, the dynamics of the disease, the patient's overall health, and other factors.Conservative therapy, surgical therapy, or their symbiosis may be included in the treatment plan at the discretion of the specialist.
Conservative approaches include pharmacological and non-pharmacological treatments.These treatments may be the only treatments in the initial stages of the disease, that is, when the first symptoms appear, and in 100% of cases they complement surgical methods.
Expert opinion
Surgical approaches are used in advanced forms of vascular pathology.Surgical methods are divided into invasive surgery and minimally invasive surgery.They all have indications and contraindications, as well as their respective advantages and disadvantages.
One of the most popular modern treatments is the EVLT procedure (endovascular laser coagulation) of the veins of the lower limbs.Medical terminology is difficult for the untrained eye to understand.Therefore, the question arises: what is it and what is its purpose?
Lower extremity venous EVLT: preparation, surgical technique, indications, and contraindications
What is EVLT for varicose veins?Endovascular or endovenous laser coagulation (EVLC) of lower extremity veins is a minimally invasive procedure to eliminate varicose veins.
How is endovascular laser coagulation of varicose veins performed?This approach has been in place for about ten years, so the program is still being refined today.EVLT is highly technical and complex in operation, requiring not only high-quality equipment but also high-level professional training for medical staff.
This is a percutaneous endovascular procedure.This means that laser coagulation of varicose veins in the legs involves the introduction of a peripheral catheter into the venous bed.A thin laser light guide is passed through it to cauterize the vein.Under its influence, thermal burns occur, followed by adhesions in the vein walls and the lumen is occluded.The surgery will be performed under local anesthesia (a low-concentration anesthetic mixture), the effects of which are expected to last 6-10 hours.In addition to the anesthetic effect, a vasoconstrictor is achieved due to the addition of vasoconstrictors to the mixture.This reduces the risk of hematoma formation after EVLT.
All stages of EVLT were performed using duplex scanning.
Therefore, the specialist controls the laser and its location in the vein.Irrespective of the initial marking of the veins, laser treatment of varicose veins takes approximately 40 minutes.If necessary, sclerotherapy or small phlebectomy of the large variceal tributaries of the great and small saphenous veins was performed the next day.This occurs because intravascular laser coagulation has limitations on the allowed dilation of the varicose tributaries of the great saphenous vein (GSV) and small saphenous vein.For the procedure to be effective, the vein must be dilated to 25 mm in diameter.Therefore, there is no need to worry if some veins are still visible after EVLT treatment.They can be eliminated by introducing a sclerosing agent into the vein opening or by performing a puncture and then pulling the vein out and physically removing it.The study results show that such cases have good clinical results and long-lasting cosmetic results in the postoperative period without signs of recurrence.In addition, in general, the patient's social recovery is accelerated (if medical advice is followed immediately after surgery).
Laser coagulation of blood vessels in the legs: preparation stages
What preparations are needed before solidification?The preparation is not difficult.In order to perform intravascular laser coagulation of lower extremity veins, the following conditions need to be met:
- General screening of the patient's health status (general clinical blood and urine tests, RW blood test, comprehensive analysis of coagulation indicators, blood test for viral hepatitis B and C, AIDS, HIV and syphilis);
- Vein and Vascular Examination (USDS);
- Therapist's conclusion that no contraindications exist.
Medical elastic stockings need to be prepared in advance.
You will need it immediately after laser treatment for varicose veins (EVLT).Typically, doctors will prescribe Class II compression knitwear for this purpose.
Lower extremity venous EVLT: Indications and Contraindications
If laser coagulation of blood vessels in the legs is prescribed, then there are few indications: the presence of varicose veins (from stage 2 according to CEAP), dystrophic disorders of the lower legs, straight veins.
There are also a number of contraindications to removing veins in this way:
- Being overweight (obesity);
- Arterial disease of the lower extremities, with the formation of atherosclerotic plaques on the inner walls of blood vessels;
- The patient's activities are limited due to musculoskeletal system diseases, stroke, etc.;
- infectious disease;
- Inflammatory processes in the skin and subcutaneous tissue;
- Hypertension in acute phase;
- The acute phase of some chronic diseases.
Can EVLT be performed if blood clots occur?The prerequisite for surgery is that there is no thrombosis in the upper segment of the great saphenous vein.Therefore, the presence of thrombus is also a contraindication.
Is laser vein coagulation allowed during pregnancy?Till what time?
Expert opinion
EVLT surgery is prohibited during pregnancy, postpartum, and breastfeeding periods.Pregnant and lactating women are advised to use non-pharmacological conservative treatment methods because... it is necessary to exclude all possible risks to intrauterine development and the health of the born baby.
Rehabilitation after lower limb vein laser coagulation
Those undergoing intravenous EVLT (laser subcutaneous coagulation) of the lower extremities want to know if they need a sick leave certificate?Eliminating varicose veins with this method does not require long-term hospitalization.The surgery is performed on an outpatient basis and does not require bed rest.You can resume your normal lifestyle and work responsibilities the next day.The only thing that takes time is the recovery.Recovery after intravenous EVLT can take up to a month and a half.During this time, it is important to responsibly follow all advice received from your treating physician.
Daily life after surgery
Daily life after surgery needs to be regular.The proper balance between wakefulness and sleep, activity and rest, as well as food intake, health care routines, etc.To help the body recover and reduce the risk of recurrence, some lifestyle adjustments are necessary.Daily life and routines need to be more consistent to some extent with the rules of a healthy lifestyle.
What shouldn’t you do after surgery?
There are certain contraindications and limitations after varicose vein resection.First, you need to break your bad habits.Drinking alcohol and smoking are prohibited after laser coagulation, at least during recovery.Nutrition should also be balanced and appropriate to control weight.
For a few weeks after EVLT, you should avoid hot baths, as well as going to bathhouses, saunas, and swimming pools.
Body care procedures in tanning salons and beauty salons popular with women are prohibited.Women must also switch from high heels to more comfortable, low-heeled, stable shoes.
Exercise after surgery
Due to concerns about complications and recurrence, some patients wonder if they can exercise and run after EVLT?First, after laser coagulation of veins and venules, you must start moving immediately, which will reduce the risk of blood clots.Starting from the second day after surgery, walk for at least 1.5-2 hours every day.There is a peculiarity - on the first day, the patient must wear compression stockings around the clock.In addition, medical bras can only be worn during the day for a maximum period of six months, and then the doctor will choose the compression level of the knitwear during reexamination.
Exercise is allowed and even necessary!But not all types are acceptable during recovery.It is important to exclude significant physical activity such as weight lifting, strength training in the gym, etc.Can I run after laser vein coagulation?Experts ban fast running as a form of shock loading.These also include jumping and twitching.Such loading after surgery is highly undesirable.
Complications after EVLT
Like any other surgery, there are potential complications with lower extremity vein laser coagulation.Adverse consequences of postoperative laser coagulation are uncommon and some are extremely rare (1:10,000).Therefore, this method is considered the most effective.However, there are following complications to be aware of after EVLT surgery:
- Thrombophlebitis;
- deep vein thrombosis;
- pulmonary embolism;
- burn;
- Paresthesia;
- High fever.
Is there normal pain after EVLT and how long does it last?What if your leg is strained and swelling occurs?Which of the following could be considered a complication after EVLT?
Expert opinion
Large veins coagulate to form dense cords that appear red.Typically, compaction and redness at the puncture site occur 7-10 days after endovascular laser coagulation (EVLC).This phenomenon is normal, but is only temporary.Additionally, when applied topically, it fades quickly.
Some patients report that their legs hurt and become numb during the first two days after laser vein coagulation.These unpleasant sensations are more likely related to the unusual wearing of medical knitwear than to the treatment procedure itself.Persistent pain and tightness in the venous bed rarely occur.They last no more than a month and a half and then disappear on their own.It is worth noting that on the first day, temperatures no higher than 38°C may occur due to coagulation of blood vessel wall proteins.After EVLT, the doctor will inform the patient of all possible complications and advise on what to do in the specific situation.
Pregnancy after EVLT
EVLT of pregnancy veins does not interfere with pregnancy in any way.Instead, the absolute right step to take when planning a pregnancy is to address the problem of varicose veins.Therefore, the answer to the question of whether to do laser coagulation is obvious.Because during pregnancy, the load on blood vessels will increase, and the condition will 100% worsen.Pregnancy does not include surgical intervention.Only in difficult cases, when the situation is critical, can the attending physician prescribe radical treatment for varicose veins to pregnant women.
When pregnancy occurs after EVLT, measures should be taken to prevent recurrence.
For this purpose, it is recommended to wear medical compression stockings, perform gymnastic exercises, self-massage the limbs and use intravenous tonics.Foot cream containing chestnut and ginkgo leaf extracts is ideal during pregnancy due to its properties.Its ingredients are natural, which means the product is safe for the health of expectant mothers and babies.