Beautiful legs are the dream of every woman. Unfortunately, many of the fair sex develop varicose veins. This pathology occurs not only in older women, but also in young girls. Due to varicose veins, the legs lose their attractiveness. After all, bulging and tortuous veins appear on them. This leads to the appearance of complexes about their appearance in many women.
In addition to the psychological aspect, varicose veins are also dangerous for physical he alth. In the early stages of the pathology, fatigue in the legs is noted after a long walk, gradually discomfort begins to occur at rest. If the disease is not treated, there is a risk of developing thrombophlebitis. This complication, in turn, can lead to cessation of blood supply to the lower extremities, and even death due to acute right ventricular failure.
Modern medicine is advancing rapidly. For several years, for the treatment of varicose veins activelylaser techniques are used. They almost completely replaced open surgical interventions. One of the methods of treatment is endovasal laser coagulation of varicose veins. Feedback on this procedure is good. Patients who have undergone treatment report many benefits of the technique.
History of laser photocoagulation
The first use of laser systems for the treatment of vascular pathologies was mentioned in 1981. The method was based on the ability of body tissues to absorb light. The wavelength of the first lasers was 577 nm. It was found that exposure to light energy can lead to selective destruction of the vessels of the skin. In the following decade, more compact laser machines were invented.
In the late 90s, intravascular use of devices was first mentioned. For the treatment of vein pathologies, diode lasers with a wavelength of 810 nm were used. The results were published in 2001. The laser was first used to treat the great saphenous vein. Between 1996 and 2000, 252 intravascular operations were performed. In the future, the methods of endovasal treatment improved. It turned out that increasing the power of light energy can reduce the risk of complications of intravascular intervention.
What is endovasal coagulation used for?
Endovasal laser coagulation is one of the methods for treating varicose veins. It is used as an alternative to surgery and sclerotherapy. HowIt is known that varicose veins occur due to a malfunction of the valves. Due to the fact that they weaken over time, the normal blood flow changes. With varicose veins, any vessels can be affected. Due to the constant stay on the legs, most often there are problems with the large and small saphenous veins located on the lower extremities. Endovasal laser coagulation consists in sealing the affected vessel. As a result, blood cannot circulate through it and rushes into he althy veins.
The mechanism of laser action on blood vessels
How is endovasal laser coagulation of varicose veins performed? This method is based on the thermal effect of thermal energy on the endothelium. The essence of the treatment is that under the influence of laser beams, blood thickens. Light fluxes are absorbed by special cells - erythrocytes. Due to this, the rays are converted into thermal energy. Laser exposure causes a thermal burn of the endothelium, and steam bubbles appear in the blood. Thanks to these mechanisms, a clot is formed - a thrombus. It obliterates the lumen of the vein. As a result, the vessel is glued together, and subsequently completely sealed. A year later, connective tissue forms at the site of the burn.
Indications for laser coagulation
It is worth noting that only in certain cases, endovasal laser coagulation of veins is performed. Patient reviews,suffering from varicose veins, indicate that this method is not always allowed. There are a number of indications for laser vascular treatment. These include the following cases:
- Expansion of the great saphenous vein in the mouth area by 1 cm or less.
- A small amount of dilated vessels.
- Smooth course of the great or small saphenous vein.
- Impaired blood supply to the lower leg.
Endovasal laser coagulation of varicose veins is also used in other cases. However, before deciding to carry out this method of treatment, the doctor must weigh the pros and cons. If the ostium expansion of the vein is more than 1 cm, coagulation may not have the desired effect. This will require repeated surgery. The presence of pathological bends along the veins is also not considered an absolute contraindication. Sometimes in this case, endovasal laser coagulation is performed. In this case, surgeons resort to the use of two light guides instead of one.
If there are a large number of varicose veins, this method can be used, however, as practice shows, it will not bring the desired effect. Endovasal laser coagulation is the most acceptable method of treatment in violation of the trophism of the lower leg. If necessary, this method can be repeated.
Benefits of Endovasal Coagulation
Over the past 10 years, laser vascular coagulation has established itself as one of the best methods of treatment. She activelyis used in foreign countries and is being introduced into domestic medicine. EVLK (endovasal laser coagulation) has a number of advantages over traditional methods of treating varicose veins. These include:
- No scars after the procedure. Unlike open surgery, laser coagulation is a minimally invasive procedure. Therefore, after EVLT, there are no extensive hematomas and scars.
- Performing local anesthesia. Open vascular surgery is an indication for general anesthesia. As you know, this type of anesthesia cannot be performed if the patient has severe somatic diseases. In addition, recovery from local anesthesia is much faster and easier.
- Painless. Unpleasant sensations during the procedure are completely absent or minimal. The same applies to the postoperative period.
- Saving the ability to work. Endovasal laser coagulation of varicose vessels can be performed on an outpatient basis. The procedure does not take long, so the patient quickly returns to work.
- Possibility of repeated coagulation of veins.
- Low chance of complications.
- The possibility of laser coagulation in the presence of trophic ulcers on the lower extremities.
The advantages of this treatment technique are obvious. However, it is worth remembering that there are contraindications to performing laser coagulation. Therefore, before deciding on the method of treatment, it is necessary to carry out diagnosticprocedures.
Contraindications for the procedure
Contraindications for intravascular laser coagulation cannot be ignored. Even with the strong desire of the patient, treatment cannot be carried out in the following cases:
- Blood disorders with a high risk of thrombosis.
- Inflammation in the affected area.
- Pathologies due to which the patient loses the ability to actively move. Among them are diseases of the bones and joints, paralysis of the limbs.
- The presence of acute inflammatory processes in the body.
- Ischemic vascular disease of the lower extremities.
- Severe obesity.
The presence of inflammatory foci and infectious diseases are considered relative contraindications to laser coagulation. In such cases, the manipulation is carried out after the treatment of acute pathology. Also, relative contraindications include: pronounced expansion and tortuosity of the saphenous veins. In this case, the decision to perform laser coagulation is made by the doctor after an additional examination.
Preparation for the procedure
Before laser coagulation, it is necessary to undergo diagnostic procedures such as a general blood and urine test, a coagulogram, an ECG, a test for HIV infection and hepatitis. Special methods include ultrasound of the veins of the lower extremities with dopplerography. This study will help assess the condition of the valves, as well as identify blood circulation disorders.
Before the lasercoagulation should get rid of the hair on the leg. Before proceeding with the procedure, the doctor performs markings on the skin. It is performed under ultrasound guidance. First of all, the doctor notes the place of reflux (reverse flow) of blood in the large or small saphenous vein. Then the area in which the puncture of the vessel is performed is marked. It is located 3-4 cm below the first mark. After that, the surgeon marks all the orifices of blood inflows and varicose expansions.
Coagulation technique
Endovasal laser coagulation of the veins of the lower extremities is performed under local anesthesia. After anesthesia, a vein is punctured using a catheter. A light guide is inserted into the vessel. The laser is directed to the venous anastomosis. After that, tumescent anesthesia is performed - anesthesia around the pathological focus. For this purpose, a saline solution with the addition of lidocaine and adrenaline is used. Thus, it is possible to achieve not only pain relief, but also prevent the burn of he althy tissues.
After tumescent anesthesia, endovasal laser coagulation of the veins is performed. Under the influence of a light beam, the damaged areas of the vessel are obliterated. Then a special bandage is applied to the vein. Compression stockings must also be put on immediately.
Recovery after laser coagulation
Duration of endovasal coagulation is about 40 minutes. After the laser procedure, it is necessary to walk around the ward for 1 hour. Thenthe patient may leave the hospital. Control ultrasound examination of the veins of the lower extremities is performed in 2-3 days. Compression stockings should not be removed for 5 days. In the daytime, they should be worn for at least 2 months. Patients need to walk and avoid strenuous exercise. It is not recommended to sit for a long time and go to the baths, as well as take a hot bath in the first months after the operation.
What complications can develop?
What is the danger of EVLT (endovasal laser coagulation)? Patient reviews show that complications after this method of treatment develop extremely rarely. These include:
- Thrombophlebitis.
- Paresthesia - a tingling sensation along the vein.
- Inflammation and necrosis of the vessel.
Minor movement discomfort and a feeling of tightness are normal and will resolve within 2-3 days. Also, on the first day, subfebrile body temperature may disturb.
Endovasal laser coagulation of varicose veins: patient reviews
Studying the numerous reviews of people who have undergone this intervention, it is worth noting the high efficiency and a large number of advantages of the method over other methods of treatment. Among the disadvantages of laser coagulation, patients indicate the high cost of the procedure and the possibility of relapse. All women who have undergone this operation note the absence of cosmetic defects on the skin of the legs.
Endovasal laser coagulation: doctors' reviews
PoAccording to doctors, endovasal coagulation of blood vessels with a laser is one of the best methods for treating varicose veins. Despite the high cost, it is in demand among patients. However, doctors point out that in advanced cases it is not advisable to carry out endovasal coagulation.
