Laser therapy (laser coagulation): benefits and possible harms

Unfortunately, vascular pathologies have a global status. They affect people of different ages and genders. Various reasons can serve the development of varicose veins of the lower extremities, and there are many. Therefore, the statistics on the registration of vascular diseases are growing relentlessly. At the same time, science and medicine are not dormant, and the number of treatment methods is already an impressive list.

Leg without varicose veins after laser treatment

The choice of treatment regimen remains with the attending physician. Its selection determines the stage at which vascular pathology, disease dynamics, general health of the patient and other factors are detected. At its discretion, the practitioner may include conservative, surgical methods or their symbiosis in the treatment regimen.

Conservative methods include drug therapy and drug-free therapy. These methods of treatment may be the only ones in the initial phase of the disease, when its first signs appear, and in 100% of cases they are 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. They all have indications and contraindications, as well as their advantages and disadvantages.

One of the most popular modern therapeutic methods is the EVLK procedure (endovasal laser coagulation) of the veins of the lower extremities. It is difficult for an untrained person to understand medical terms. So the question is, what is it and why is it done?

Consultation with a doctor before laser vein coagulation

EVLK of the veins of the lower extremities: preparation, technique of procedure, indications and contraindications

What is the EVLK method of treating varicose veins? Endovascular or endovenous laser coagulation of the veins of the lower extremities (EVLK) is a minimally invasive process of removing varicose veins.

How is endovasal laser coagulation of varicose veins performed? This method has been used for ten years, so the procedure is improving to this day. EVLK is characterized as a high-tech and quite complex manipulation that requires not only high-quality equipment, but especially high professional training of medical staff.

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 guide light penetrates to glow the veins. Under its influence, thermal combustion and subsequent adhesion of the venous wall with obliteration of the lumen occurs. The procedure will be performed under local anesthesia (low-concentrated anesthetic mixture), its effect is calculated at 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 EVLK.

All phases of EVLK are performed by duplex scanning.

Thus the specialist controls the laser and its position in the vein. Without taking into account the previous marking of the veins, the laser treatment of varicose veins takes about 40 minutes. If necessary, sclerotherapy or miniphlebectomy of large dilated tributaries of the great and small saphenous veins is performed the next day. This is because endovasal laser coagulation has limitations in the allowable dilation of dilated tributaries of the great saphenous vein (GSV) and the smaller saphenous vein. For the procedure to be effective, the veins must have an expansion of up to 25 mm in diameter. Therefore, do not worry if veins remain visible after EVLK treatment. They will be removed by injecting sclerosants into a venous opening or performing a puncture, then removing the vein from the outside and physically removing it. As the results of research show, in such cases in the postoperative period there is a good clinical and lasting cosmetic effect, without signs of recurrence. In addition, in general, the social rehabilitation of patients is accelerated (if medical recommendations are followed immediately after surgery).

Device for treating varicose veins by endovasal laser coagulation

Laser coagulation of veins in the legs: preparatory phase

What is the preparation for coagulation? Preparation is not difficult. In order to perform endovascular laser coagulation of the veins of the lower extremities, it is necessary:

  • general examination of the patient's health (general clinical blood and urine tests, blood test for RW, comprehensive analysis of blood clotting indicators, blood tests for viral hepatitis B and C, AIDS, HIV and syphilis);
  • examination of veins and blood vessels (UZDS);
  • therapist's conclusion about the absence of contraindications.

It is necessary to prepare medical compression stockings in advance.

This will be needed immediately after laser varicose vein (EVLK) treatment. As a rule, the doctor prescribes compression class II knitwear for this purpose.

EVLK of the veins of the lower extremities: indications and contraindications

If laser coagulation of veins on the legs is prescribed, then the indications are small: the presence of varicose veins (starting from stage 2 according to CEAP), trophic disorders of the legs, direct flow of veins.

Removing veins in this way also has a number of contraindications:

  • overweight (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;
  • acute phase hypertension;
  • some chronic diseases in the acute phase.
Laser vein coagulation is prohibited during pregnancy

Can EVLK be done in the presence of blood clots? A prerequisite for surgery is the absence of blood clots in the upper segment of the trunk of the saphenous vein. Therefore, the presence of blood clots is also a contraindication.

Is laser venous coagulation allowed during pregnancy and until when?

Expert opinion

EVLK surgery during pregnancy and after childbirth, with lactation, is prohibited. Conservative therapies without drugs are recommended for pregnant and breastfeeding 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 lower extremity veins

Those who are prescribed EVLK (laser subcutaneous coagulation) of the veins of the lower extremities are interested in whether it is necessary to open sick leave? It does not take long to be in the hospital to remove varicose veins with this method. The procedure is performed on an outpatient basis and does not require bed rest. He will be able to return to his usual way of life and work obligations the very next day. The only thing that will take time is rehabilitation. Recovery after EVLK veins can take up to a month and a half. During this time, it is important to responsibly follow all the recommendations received from your doctor.

Daily regimen after the procedure

The daily regimen in the postoperative period requires regularity. Competent ratio of wakefulness and sleep, activity and rest, as well as food intake, health procedures, etc. In order for the body to recover and reduce the risk of recurrence, some lifestyle adjustments need to be made. The daily routine and its routine will have to come somewhat closer to following the rules of a healthy lifestyle.

What should not be done after the procedure?

After the procedure of removing varicose veins, there are certain contraindications and restrictions. First of all, you need to get rid of bad habits. Alcohol and smoking after laser coagulation are prohibited, at least during rehabilitation. The diet should also be balanced and proper to control weight.

A few weeks after EVLK, you should stop taking hot baths as well as visiting baths, saunas and swimming pools.

The ban includes tanning beds, a favorite of the fairer sex, and body care procedures in beauty salons. Women will also need to change heels to more comfortable shoes with a low, stable heel.

Physical activity after laser vein coagulation

Sports activities after the procedure

Fearing complications and recurrence, some patients wonder if sports and running are allowed after EVLK? For a start, after laser coagulation of veins and miniphlebectomy, you must start moving immediately, this will reduce the risk of thrombus formation. Starting from the day after the operation, daily walking should last at least 1, 5-2 hours. There is one peculiarity - in the first days, the patient must be constantly in compression stockings. Furthermore, wearing medical underwear is only provided during the day and for up to six months, after which the doctor will select the compression class of the knitwear for the second examination.

Sport is allowed and even necessary! But not all of its types are allowed during the rehabilitation period. It is important to exclude significant physical activities, such as lifting weights, strength exercises in gyms, etc. Can I run after laser vein coagulation? Experts forbid fast running as a type of impact load. This also includes jumping and catching. Such loads after surgery are highly undesirable.

Complications after EVLK

Like any other operation, laser coagulation of the veins of the lower extremities has potential complications. Adverse effects of laser coagulation in the postoperative period are rare, and some are even extremely rare (1: 10000). Therefore, the method is recognized as the most effective. However, it is necessary to be aware of such complications after EVLK surgery:

  • thrombophlebitis;
  • deep vein thrombosis;
  • pulmonary embolism;
  • Burns;
  • paresthesia;
  • hyperthermia.

Are the pains after EVLK normal and how long do they last? What to do if your leg pulls and there is swelling? Which of the following can be considered a complication after EVLK?

Expert opinion

The large vein after coagulation forms a thick band with redness. As a rule, such a seal appears at the site of the puncture and redness 7-10 days after endovasal laser coagulation (EVLK). This phenomenon is normal, but temporary. In addition, it regresses rapidly when used topically.

Some patients notice that the leg hurts and becomes numb during the first two days after laser vein coagulation. These uncomfortable sensations are more likely to be associated with the unusual wearing of a medical jersey than with the treatment process itself. Pain and tension in the venous bed are rarely observed. They do not last longer than a month and a half and pass on their own. It is worth noting that on the first day, in response to protein coagulation in the vessel wall, a temperature not exceeding 38 ° C may occur. After EVLK, the doctor will inform the patient of all possible complications and give recommendations on how to behave in a particular case.

Pregnancy after EVLK

The performed EVLK of the pregnancy vein cannot interfere in any way. On the contrary, when planning a pregnancy, solving the problem of varicose veins is absolutely the right step. Therefore, the answer to the question of whether to do laser coagulation or not, the answer is obvious. Because during pregnancy the load on the vessel will increase and the disease will worsen 100%. Pregnancy precludes surgery. Only in difficult situations, when the situation is critical, the attending physician can prescribe a radical method for the treatment of varicose veins for a pregnant woman.

When pregnancy occurs after EVLK, measures should be taken to prevent recurrence.

For that purpose, wearing a medical compression jersey, performing gymnastic exercises, limb self-massage and applying vein toning cream are shown. Foot cream with chestnut and ginkgo biloba extracts is ideal because of its qualities during gestation. Its composition is natural, which means that the product is safe for the health of the future mother and baby.