Treatment of varicose veins laser varicose veins, coagulation, surgery

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Varicose disease is a disease in which the destruction of the valvular apparatus the lower limb veins resulting from inadequate blood flow, the veins gradually expand.

treatment of varicose veins laser

For the first time, it is merely a cosmetic error, but with the progression of the disease occurs, clinical symptoms, until the danger of complications – thrombophlebitis and thromboembolism.

Because the mechanism of varicose veins, is still in the anatomical failure, conservative treatment methods are ineffective here. Despite the increasing advertising of the disease, all the drugs can be considered only as a means of preventing progression of the disease in the early stages.

Logically, the most radical treatment for this disease is surgery. The goal of the operation is to remove a very enlarged venous channel. This is achieved or the removal of varicose veins, or its game over.

Until recently, the most common operation for varicose veins is Stripping surgery, i.e. complete removal of the failed vein – a rather unpleasant and traumatic procedure done under General anesthesia, after which the scars remain, and the long-term past of a hematoma.

In recent decades, the practice introduced for other methods of surgical treatment of varicose veins: electrocoagulation, sclerotherapy, radiofrequency ablation, and others. However, of all proposed invasive methods the most popular method of laser coagulation of veins.

The advantages of laser coagulation of varicose veins

Laser coagulation of the vein was used for the first time just a few more than 10 years ago. Today, this procedure is the main method of treatment of varicose disease abroad, growing every day in popularity and in Russia. This operation is constantly improving.

The main advantages of laser coagulation of varicose veins:

  • Instead, many of the pieces were performed by a single puncture. After the operation, almost without subcutaneous hematoma.
  • There is no need for General anesthesia or spinal anesthesia.
  • Painless. The surgery is performed under local anesthesia, the patient feels no pain at all or some of the discomfort.
  • The ability to perform surgery in an outpatient setting, hospitalization is not necessary.
  • The lack of need long-term rehabilitation. After 1.5-2 hours after the treatment, you can return to your normal regime. Work capacity are not violated.
  • The lowest percentage of complications compared with other methods.
  • The possibility of operating in the presence of trophic ulcers.
  • Laser coagulation can be repeated several times.

The essence of the treatment of varicose veins laser

The indication for the procedure is the presence of varicose veins. The most frequently offered laser treatment with a slight extension of the venous tributaries.

It is not appropriate treatment for the extension of the saphenous veins more than 10 mm in diameter, and in the presence of a high ink-spread veins. In this case, this process is inefficient and technically impossible.

If you have a lot of varicose tributaries should also be deleted. Laser treatment in this case becomes economically feasible (this method is quite costly).

Laser treatment of varicose veins – a method very young, so development continues. There have been discussions about the optimal power of the laser radiation, developed and implemented new fibres.

The method of laser coagulation is that the effects of the laser energy leads to the "boiling" of the blood in the vessel, the heat influence on the inner walls of the vein, which causes thermal burns and adhesion of the vein wall with the obliteration of their lumen.

This eliminates the anatomical basis for varicose veins – extended Vienna disappears and is transformed into a connective tissue strand (or simply-scar), which is not visible under the skin. It is further normally coupled resorption in the vein.

How is the procedure

In the classic version of the laser treatment removes all indentations.

  • Under ultrasonic control in vertical position, which is marked in Vienna, the subject of endovenous laser ablation: the projection of the veins be marked on the skin. Are also its tributaries.
  • Through a small puncture (after prior local anesthesia) is performed the puncture in the vein, with a venous catheter. In fact, the injection of anesthetic before the puncture is only a painful sensation during this operation.
  • Through the catheter is inserted the laser fiber. Under ultrasound, the fiber is done on site in Vienna.
  • The tumescent anaesthesia infiltration around the changes of the veins in combination with a solution containing the anesthetic lidocaine, epinephrine and saline. This intrusion provides not only anesthesia, but also protects the surrounding tissue from the burns.
  • Then carry out the procedure – to include the laser light and to the opposite traction of the fibres at a certain speed (the speed of movement of the light guide is typically a standard developed on the basis of clinical trials, but may vary depending on vein diameter and length of laser radiation).
  • Varicose tributaries are removed with the help of micro-holes.
  • After the procedure a compression bandage is used (a special latex pads on the vein, which bind to skin with a bandage) and the compression socks II the degree of compression.

Compression socks are available to advise the doctor for consultation.

treatment of varicose veins

The main contraindications are:

  • Inflammatory changes of the skin and subcutaneous tissue at the site of the planned procedure.
  • The diameter of the vein more than 1 cm
  • The impaired walking due to other diseases (arthrosis, consequences of strokes and other diseases of the lower extremities).
  • Acute infectious disease or decompensation of chronic physical disease.
  • Different diseases of the arteries of the lower extremities. In these diseases disrupted the flow of the blood in the legs, and laser treatment can aggravate the condition.
  • An increased amount of platelets in the blood (increased risk for thrombosis).
  • Thrombosis repeated in history.
  • Pregnancy and breast-feeding.
  • Obesity, high as it complicates the necessary post-operative compression.

Preparation for the laser treatment

Before surgery it is necessary to review. As a rule, is assigned a standard set of tests:

  • General analysis of blood, urine.
  • The biochemical analysis.
  • Study of blood clotting.
  • Blood for markers of viral hepatitis, HIV, syphilis.
  • EKG.
  • A chest x-ray.
  • A review of the doctor.
  • The gynecologist in women.

In addition to the standard questions, it is necessary to do ultrasound examination of the veins of the legs.

Pre-buy and compression socks. They are specially selected by the physician. Usually, they can be purchased in the same hospital, where surgery is planned or in a separate cabin.

Before surgery you need to shave my legs.

In the postoperative period

The whole operation takes no more than 40 minutes. After the surgery is necessary to walk for one hour, after which the patient can go home.

  • After 2-3 days it is necessary the supervision of a physician with the mandatory ultrasound.
  • If surgery is needed on the other foot, is assigned at least a week.
  • Compression socks are not removed within five days, then within 1.5-2 months worn only during the day. In this context, it is not recommended to operate in the hot season.
  • The recommended daily walk with him for at least 1 hour.
  • Some time is not good veins and in places preserved small holes bruising and pigmentation.
  • For several weeks avoid prolonged static load on the foot, prolonged sitting, visiting the baths and saunas, hot baths.

Possible consequences and complications, laser

Procedure causes aseptic inflammation and necrosis of blood vessels.

Therefore, it cannot be:

  • Mild pain in the limb for 2-3 days.
  • The sense of tension along the veins, discomfort when bending-unbending.
  • A brief rise in temperature to subfebrile digits.
  • The formation of bruises.

All these unpleasant symptoms are transient and go away within a few days.

It should also be noted the possibility of relapse : lack of games at the end of the vein lumen leads to its recanalization – the restoration of blood flow and re-expansion. Most often this happens when it is not in compliance with postoperative recommendations.

Very rarely can occur in more severe complications – thrombophlebitis coagulated veins or deep vein thrombosis. These complications occur in 4 to 6 days after surgery, you need to be aware of the possibility of and symptoms for which you should immediately contact your doctor:

  • The emergence of severe pain in the leg.
  • The Temperature rise above 38 degrees.
  • The appearance of redness, indurations, tenderness along course of vein.
  • The appearance of leg edema.

The main disadvantage of laser removal of varicose veins is the cost. This operation is paid. The cost of the operation – from 500 to 1000 dollars.

The price depends mainly on the volume of the transaction (taking into account the length of the vein, it is necessary to remove and the number of its tributaries), the type of equipment that is used (the processing of the laser radial is more expensive).

Prices on compression socks also small and do not skimp on it is worth it.

varicose veins

However, reviews of the patients that laser obliteration of the veins in the vast majority of positive.

Without anesthesia, no significant pain! After 40 minutes surgery can walk after 2 hours can go home and return to their normal business.

The effect is noticeable already after a few days: no pain, no swelling, no protruding wires, bands under the skin. The main opinion of the patient: surgery with a laser is worth the money.