Unfortunately, vascular pathology has a global status.People of different ages and genders are exposed to them.Various reasons can contribute to the development of varicose veins on the lower legs, and there are many of them.Therefore, statistics on the registration of vascular diseases inevitably grow.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 their conservative, surgical or symbiotic methods in the treatment regimen.
Conservative methods include drug and non-drug therapy.This treatment method may be the only one in the early stages of the disease, when the first signs appear, and in 100% of cases it is 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 lower leg veins.It is difficult for untrained people to understand medical terms.Therefore, the question arises: what is it and what is it done for?
EVLT of lower leg veins: preparation, procedure technique, indications and contraindications
What is EVLT treatment for varicose veins?Endovascular or endovenous laser coagulation of the lower leg veins (EVLC) is a minimally invasive process to eliminate varicose veins.
How is endovascular 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 in the leg involves the introduction of a peripheral catheter into the venous bed.Through it a thin laser light guide penetrates to burn the vein.Under its influence, a thermal burn occurs and the subsequent adhesion of the vein wall with the destruction of the lumen.The procedure will be performed under local anesthesia (low concentration anesthetic mixture), 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.
Therefore, the specialist controls the laser and its position in the vein.Regardless of the initial marking of the 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 happens 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 vein 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 removed by inserting the sclerosant into the mouth of the vein or making a puncture, then taking out the vein and removing it physically.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, the patient's social recovery is accelerated (if medical recommendations are followed immediately after surgery).
Laser coagulation of blood vessels in the leg: preparatory stage
What is the preparation for freezing?Preparation is not difficult.In order for endovascular laser coagulation of the lower limb veins to be performed, the following are required:
- general examination of the patient's health status (general clinical blood and urine tests, blood tests for RW, comprehensive analysis of blood coagulation indicators, blood tests for hepatitis B and C viruses, 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 varicose vein laser treatment (EVLT).As a rule, doctors prescribe class II compression knitwear for this purpose.
EVLT of lower leg veins: indications and contraindications
If laser coagulation of the blood vessels in the legs is prescribed, then the signs are few: the presence of varicose veins (starting from stage 2 according to CEAP), trophic disorders in the lower part of the legs, straight veins.
Removing veins in this way also has some contraindications:
- overweight (obesity);
- arterial disease in the lower part of the legs, 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 perform EVLT if there is a blood clot?A prerequisite for the operation is the absence of a blood clot in the upper part of the saphenous vein trunk.Therefore, the presence of blood clots is also a contraindication.
Is laser vein coagulation allowed during pregnancy and until when?
Expert opinion
EVLT surgery during pregnancy and after delivery, during breastfeeding, is prohibited.Non-drug conservative therapy methods are recommended for pregnant and lactating women, because... it is necessary to exclude all possible risks for intrauterine development and the health of the unborn child.
Recovery after laser coagulation of lower leg veins
Those who are prescribed EVLT (laser subcutaneous coagulation) from the lower leg veins are wondering if it is necessary to open a sick leave certificate?To eliminate varicose veins using this method, there is no need to stay in the hospital for a long time.This 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 recovery.Recovery after vein EVLT can take a maximum of one and a half months.During this period of time, it is important to follow all recommendations received from the attending physician responsibly.
Daily routine after the procedure
The daily routine in the postoperative period requires regularity.The correct 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 lifestyle.Routines and daily routines need to be approached to some extent to comply with the rules of a healthy lifestyle.
What can 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 freezing are prohibited, at least for the recovery period.Nutrition should also be balanced and suitable for weight control.
For several weeks after EVLT, you should avoid taking hot showers, as well as visiting baths, saunas and swimming pools.
Tanning salons, which are preferred by the fair sex, and body care procedures in beauty salons are prohibited.Women should also change their high heels to more comfortable shoes with low, stable heels.
Exercise after the procedure
Afraid of complications and recurrence, some patients wonder if sports and running are allowed after EVLT?Let's start with the fact that after vein laser coagulation and miniphlebectomy, you must immediately start moving, this will reduce the risk of blood clots.Starting from the next day after surgery, walking every day should take at least 1.5-2 hours.There is one peculiarity - during the first days, the patient must remain in compression stockings all the time.Further, the wearing of medical underwear is provided only during the day and for a period of up to six months, then the doctor will choose a compression class of knitwear during the re-examination.
Sports are allowed and even necessary!But not all types are acceptable during the recovery period.It is important to exclude important physical activities, such as weight lifting, strength training in the gym, etc.Is it possible to run after vein laser freezing?Experts forbid fast running as a form of shock loading.This also includes jumping and jerking.Such a load after surgery is very undesirable.
Complications after EVLT
Like any other operation, laser coagulation of lower leg veins has potential complications.Unwanted laser coagulation consequences in the postoperative period are rare, some are even very rare (1:10,000).Therefore, this 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
Large veins after coagulation form a dense cord with redness.As a rule, such compaction at the puncture site and redness occurs 7-10 days after endovascular laser coagulation (EVLC).This phenomenon is normal, but temporary.In addition, it quickly backfires when used locally.
Some patients find that their legs hurt and become numb in the first two days after vein laser coagulation.This unpleasant sensation is more likely to be associated with wearing unusual medical knitwear than with the treatment procedure itself.Rarely there is pain and tension along the venous bed.They last no more than a month and a half and disappear on their own.It should be noted that on the first day, in response to the coagulation of vessel wall proteins, 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 certain cases.
Pregnancy after EVLT
Pregnancy vein EVLT should not interfere with pregnancy at all.On the other hand, when planning a pregnancy, the absolutely correct step is to solve the problem of varicose veins.Therefore, to the question of whether to do laser freezing or not, the answer is clear.Because during pregnancy, the load on the vessels will increase, and the disease will worsen 100%.Pregnancy does not include surgical intervention.Only in difficult situations, when the situation is critical, the attending physician can prescribe a radical method to treat varicose veins to pregnant women.
When pregnancy occurs after EVLT, measures should be taken to prevent recurrence.
For this purpose, wearing compression medical stockings, performing gymnastic exercises, self-massaging the limbs and using vein-tonic creams are recommended.Foot cream with extracts of chestnut and ginkgo biloba is very suitable for its benefits during pregnancy.The composition is natural, which means that the product is safe for the health of pregnant women and babies.