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Laser coagulation of varicose veins (EVLT)


Varicose veins is a disease quite common, especially among middle-aged women. And if unremarkable little bruises on the shins in the beginning you almost don't bother, with time, to deteriorate not only the appearance. With the advent of well-marked nodes along the veins of the legs begin to swell, hurt, you become difficult to walk for long periods of time and have to part forever with stylish shoes.

After prolonged conservative treatment, surgeons phlebologists offer surgery to remove the varicose veins. Of course, it's way out. Alternative to surgery, laser photocoagulation of varicose veins, the newest minimally invasive method.

It would seem that the question is solved simply. But, as traditional methods of treatment of varicose veins, endovenous laser coagulation is performed strictly according to indications. One desire of the patient, unfortunately, is not enough. Consider what types of varicose veins can be cured by laser.

The list of indications for the procedure

  1. Absolute indications for laser treatment - a slight extension of the venous tributaries;
  2. Successfully applied endovasal laser obliteration, and when disturbed the trophic lower leg. This method saves the patient from having an open ligation or endoscopic excision of the vessel. It is preferable to apply the method because laser

coagulation can be repeated several times.

действие лазера на вену

Laser photocoagulation has been used successfully in the treatment of varicose changes of the great saphenous vein. But effective endovascular technique only in cases where the vessel is expanded by not more than 10 mm When the extension near the mouth more than this size, the technique is ineffective. In addition to the level of expansion has a value and the course of the saphenous veins. If big or small Vienna located exactly, it is possible to use one laser light guide. If the vascular are in physiological curves, it requires two optical fibers which are positioned on both sides of the bend.

Before performing endovenous laser coagulation phlebologist assigns the appropriate diagnostic procedure and determines the likely outcome. Now let's talk about contraindications for laser treatment of varicose veins. Conditionally they can be divided into 2 subgroups:

  • A local associated with disorders in the area of the planned operation;
  • Common associated with other acute or chronic pathologies.

Local contraindications

  1. Any inflammation of the skin and subcutaneous layer in the region where it is planned to carry out endovenousthe ablation laser.
  2. Varicose veins more than 10 mm.
  3. Diseases affecting the ability to move freely. The technique of endovenous laser coagulation of veins involves active walking after the procedure, ie must create a certain load on the lower limbs. If for any reason (arthritis, other diseases of the lower limbs), walking is impossible, the ablation laser is not carried out.
  4. In the presence of another disease, need help in the first place.
  5. At thrombophilia. This is a disease in which the blood impaired function of platelets and there is a high risk of thrombosis.
  6. Under ischemia. If the vascular of the legs suffer from chronic ischemia, endovascular coagulation do not, in order not to provoke the escalation of the disease.
  7. If you cannot provide the necessary compression of the lower extremities (obesity, high).

General contraindications

подкожная вена на ноге

Now what exactly is laser coagulation of veins.

To conduct minimally invasive surgery uses a laser fiber. It is a device with a flexible tube, through which passes the healing beam. Before the procedure, the doctor makes a small incision in the region through which will affect the patient's vein. The laser pulse enters the bloodstream. Exposure to high temperatures it forms steam bubbles which come into contact with the inner sheath of the vein (endothelium).

With the aid of steam exposure and the coagulation process, i.e. the bonding of the vascular wall affected by varicose veins. It becomes clear that laser coagulation of varicose veins is not directly directed to the vessel, and indirect.

The duration of the whole procedure does not exceed 40 minutes. If we consider the process in steps, first the doctor acts directly on a large vein, valves which do not work correctly. Coagulation causes the blood to become normal due to it moving in a healthy blood vascular. The second step - exposure of the varicose tributaries of the great vein.

After this procedure, the diseased vein like "sealed", the patient vascular wall with time to develop the connective tissue structure.

Be ready

Make the decision on application of endovasal laser coagulation is a surgical phlebologist, he will prescribe the necessary examination. The first thing to do before the procedure - to pass an ultrasound of vascular of lower extremities. The results will allow the doctor to make a conclusion on the work of the venous system of the lower leg: the patency of the blood vascular, as a venous valve apparatus.

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In addition to ultrasound examination must pass the clinical laboratory a minimum: blood and urine tests. In principle, all preparatory survey will not take more than one or two days.

In addition to instrumental and laboratory diagnostics preparation includes collecting a detailed medical history to identify allergic reactions to medication, to be used.

Does not hurt

The comfort of endovasal laser coagulation is provided by a certain type of local anesthetic, which in medical language is called tumescent. With this type of anesthesia uses a special three-component solution, which includes saline, epinephrine and lidocaine. Each component of the solution is given its own function:

  • Physiological saline permeates the surrounding vessel tissue;
  • Adrenaline narrows the blood vascular;
  • Lidocaine which is an anesthetic.

Thus, when performing tumescent anesthesia around the varicose vessel creates a makeshift "case" in which the operation is conducted.


It is clear that the average man worried about the recovery period - whether special costs, how long the disability, whether aching leg after EVLT. I hasten to reassure you - no complex rehabilitative programs laser coagulation is not required. The benefits of the "office" surgery, which is this operation is the restoration of normal lifestyle immediately after the intervention.

Of course, this does not mean that after endovenous laser coagulation of veins you can go to work as a loader or in full dig up the garden at the cottage. First, three days should wear compression stockings. And convenience wear recommended first 3 - 5 days. Subsequently, a compression stocking is worn only on the day, the greatest period of its use is 60 days.

Dragging pain in the course of the former varicose veins can be a little uncomfortable during the week, rarely 2. After surgery, avoid complications, patients are encouraged peaceful walk at least 40 minutes a day. And all other restrictions on the regime there.

The choice of compression underwear

If you are preparing for the treatment of varicose veins using laser, better buy a compression stocking will have to advance. But it is not necessary to surf the online stores in search of cheap products. Get the model that you recommend your doctor and do it only through the pharmacy network.

What complications can arise

Surgery endovenous coagulation thoughminimally invasive, but the intervention in the body, so you should give you the statistics of possible complications. The method began to be widely used somewhere in the world since 2000, and among the huge number of patients who have undergone EVLT, have been identified:

  • A single in the world, cases of thrombosis, purulent complications in the course of the varicose vein;
  • Thrombophlebitis was observed in 5 - 12% of patients after endovenous laser coagulation;
  • Paresthesia is up to 1% of complications of EVLT;
  • The most common and innocuous complication is a hematoma on the site of the intervention (24%), which disappeared after a few days;
  • Slight hyperthermia (rare).

Painful symptoms are eliminated through the use of non-steroidal drugs.

These low rates of postoperative complications prove high effectiveness of laser treatment for varicose veins. To confirm a successful outcome for the patient after surgery schedule follow-up ultrasound of the blood vascular.

How to prevent the recurrence of varicose disease

Insidious varices may appear again. Of importance here are not only genetic predisposition, but also your habits. In order to meet this disease, remember:

  1. You need to move a lot. But to do it with no load and light shoes.
  2. Swimming is an excellent method of prevention of varicose veins.
  3. For fashionistas. Stylish studs appropriate to the occasion, for everyday wear, your ultimate heel height - 5 - 6 see
  4. Weight. Extra pounds - a type of load for your feet. And load constant. Get rid of it.
  5. Indulge yourself with a cold shower, paying more attention to the lower extremities.
  6. If you have undergone EVLT, occasionally watch a phlebologist. It is better to do 1 every six months. If necessary, the doctor will prescribe you a prophylactic course of venotonic drugs, will recommend a compression garment.
  7. Follow the skin condition of the feet. A cut, the wound should be properly treated in order to prevent the penetration of pathogenic germs into the blood.

Though endovenous laser coagulation surgery is a common and widely used, try to avoid it.