Beautiful legs are every woman’s dream. Unfortunately, many women develop varicose veins. This pathology occurs not only in older women, but also in young girls. Due to varicose veins, the legs lose attractiveness. After all, bulging and convoluted veins appear on them. This leads to the appearance of complexes about their appearance in many women.
In addition to the psychological aspect, varicose disease is dangerous for physical health. In the early stages of pathology, fatigue in the legs after a long walk is noted, gradually discomfort begins to occur and at rest. If the disease is not treated, there is a risk of thrombophlebitis. This complication, in turn, can lead to a cessation of blood supply in the lower extremities, and even death due to acute right ventricular failure.
Modern medicine is moving forward rapidly. For several years, laser techniques have been actively used to treat varicose veins. They almost completely replaced open surgical interventions. One of the treatment methods is endovasal laser coagulation of varicose veins. Reviews about this procedure are good. Patients who have undergone treatment, note many of the advantages of the technique.
History of Laser Coagulation
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 next decade, more compact laser systems were invented.
In the late 90s, the intravascular use of devices was first mentioned. In order to treat vein pathologies, diode lasers with a wavelength of 810 nm were used. In 2001, the results were published. For the first time, a laser was used to treat a large saphenous vein. Between 1996 and 2000, 252 intravascular operations were performed. In the future, endovasal treatment techniques have 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 treatments for varicose veins. It is used as an alternative to surgery and sclerotherapy. As you know, varicose veins occur due to disruption 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 healthy veins.
The mechanism of laser action on blood vessels
How is endovasal laser coagulation of varicose veins carried out? 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. Luminous flux is absorbed by special cells - red blood cells. Due to this, the rays are converted into thermal energy. Laser exposure causes a thermal burn of the endothelium, and vapor bubbles appear in the blood. Thanks to these mechanisms, a clot forms - a blood clot. It obliterates the lumen of the vein. As a result, the vessel sticks together, and subsequently completely seals. A year later, connective tissue forms at the burn site.
Indications for laser coagulation
It is worth noting that only in certain cases, endovasal laser coagulation of the veins is performed. Reviews of patients suffering from varicose veins indicate that this method is not always allowed. There are a number of indications for laser treatment of blood vessels. These include the following cases:
- Dilation of the great saphenous vein in the mouth area by 1 cm or less.
- A small number of dilated vessels.
- Equal course of a large or small saphenous vein.
- Violation of the 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 estuary widening of the vein is more than 1 cm, coagulation may not have the desired effect. This will require repeated surgical intervention. The presence of pathological bends along the veins is also not considered an absolute contraindication. Sometimes in this case, endovasal laser coagulation is performed. At the same time, surgeons resort to using two optical fibers instead of one.
If there is a large number of varicose veins, this method can be used, however, as practice shows, it will not bring the desired effect. In violation of trophic tibia, endovasal laser coagulation is the most appropriate treatment. If necessary, this method can be repeated.
Benefits of Endovasal Coagulation
Over the past 10 years, laser coagulation of blood vessels has established itself as one of the best treatments. It is actively used in foreign countries and is being introduced into domestic medicine. EVLK (endovasal laser coagulation) has several advantages over traditional methods of treating varicose veins. These include:
- Lack of scars after the procedure. Unlike open surgery, laser coagulation is a minimally invasive procedure. Therefore, after conducting EVLK, extensive hematomas and scars are not observed.
- 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.
- Painlessness. Unpleasant sensations during the procedure are completely absent or minimal. The same applies to the postoperative period.
- Preservation of disability. Endovasal laser coagulation of varicose vessels can be performed on an outpatient basis. The procedure does not take much time, so the patient quickly returns to work.
- Possibility of repeated coagulation of veins.
- Low likelihood of developing 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 a method of treatment, diagnostic procedures should be performed.
Contraindications to the procedure
Contraindications for intravascular laser coagulation cannot be ignored. Even with the patient’s great desire, treatment cannot be carried out in the following cases:
- Blood diseases in which there is a high risk of thrombosis.
- Inflammation in the affected area.
- Pathologies due to which the patient loses the ability to actively move. Among them - diseases of bones and joints, paralysis of limbs.
- The presence of acute inflammatory processes in the body.
- Ischemic damage to the vessels 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 treatment of acute pathology. Relative contraindications also 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 such diagnostic procedures as a general analysis of blood and urine, a coagulogram, an ECG, a study 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 violations of blood circulation.
Before laser coagulation, you should get rid of leg hair. Before starting the procedure, the doctor performs markings on the skin. It is carried out under the supervision of ultrasound. First of all, the doctor notes the place of reflux (reverse current) of blood in a 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 mouths of the blood flow and varicose veins.
Coagulation technique
Endovasal laser coagulation of the veins of the lower extremities is performed under local anesthesia. After anesthesia, a vein puncture is performed using a catheter. A fiber is introduced 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, use saline with the addition of lidocaine and adrenaline. Thus, it is possible to achieve not only anesthesia, but also to prevent a burn of healthy tissues.
After tumescent anesthesia, endovasal laser coagulation of the veins is performed. Under the influence of a light beam, damaged sections of the vessel are obliterated. Then a special bandage is applied to the vein. You also need to immediately put on compression stockings.
Recovery after laser coagulation
The duration of endovasal coagulation is about 40 minutes. After the laser procedure, you must walk around the ward for 1 hour. Then the patient can leave the hospital. Control ultrasound examination of the veins of the lower extremities is performed after 2-3 days. Compression stockings should not be removed within 5 days. In the daytime they should be worn for at least 2 months. Patients need to take walks and avoid physical exertion. It is not recommended to sit and visit the baths for a long time, as well as take a hot bath in the first months after the operation.
What complications can develop?
What is the danger of EVLK (endovasal laser coagulation)? Testimonials of patients 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.
Slight discomfort during movement and a feeling of tension are normal phenomena and disappear within 2-3 days. Also, in the first day, subfebrile body temperature can be disturbing.
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 treatment methods. Among the disadvantages of laser coagulation, patients indicate the high cost of the procedure and the possibility of relapse. All women who underwent this operation noted the absence of cosmetic defects on the skin of their legs.
Endovasal laser coagulation: reviews of doctors
According to doctors, endovasal coagulation of blood vessels with a laser is one of the best treatments for varicose veins. Despite the high cost, it is in demand among patients. However, doctors indicate that in advanced cases, endovasal coagulation is not advisable.