Varicose veins are not only an aesthetic problem, but also a serious pathology requiring complex treatment.
Soreness, heaviness and swelling of the extremities, night cramps - that's what awaits patients who missed the chance of early onset of therapy.
One of the methods to combat the disease is endovascular laser obliteration of varicose veins( EVLO).Sometimes this technique is also called laser coagulation.
Contents of
- What kind of method is this?
- Mechanism of Action
- Who will help EVLO?
- General and local contraindications
- Preparatory phase
- Procedure procedure
- Postoperative period
- Possible complications
- From the practice of procedure
- The cost of the procedure in the Russian Federation
What kind of method is this?
EVLO is a modern, minimally invasive procedure that, through laser radiation, can eliminate blood reflux in the superficial and perforating venous system. This method appeared about 10 years ago and immediately gained popularity in the field of vascular surgery.
Endovasal obliteration is considered to be a low-injury and rapid method. It belongs to the category of "office surgery", since the intervention itself lasts no longer than an hour, and the postoperative period lasts up to 4 hours. Then the patient can go home and return to work.
Vascular surgeons have tremendous experience in carrying out EVLO, however, this does not make the procedure less complicated technically. High professionalism of specialists allows reducing the risk of complications and making the intervention quick and safe for the patient.
Mechanism of action
The principle of the obliteration is based on the temperature action of the laser beam on the inner surface of the vessel and blood.
The resulting impulse provokes the appearance of vapor bubbles in the bloodstream. The latter are in contact with the endothelium of the vein, as a result of which proteins are damaged.
To ensure that the destruction processes in the vessel wall are absolute, it is necessary that in the lumen of the vein there is a necessary radiation density. Temperature damage should cause "charring" of the vessel wall, and black color even more allows the vein to warm up.
Features of laser exposure are as follows:
- direct action allows you to reduce the power of the beam;
- using advanced LEDs allows to increase the area of the procedure, but at the same time to reduce the heating of the tip of the LED;
- the formation of a circular spot during laser operation makes the beam effect more accurate;
- the above points can reduce the risk of perforation and other complications.
After completion of the procedure, intravascular changes continue for a week. Formation of necrosis occurs. The thrombus, which was in the lumen of the vein, is replaced by a connective tissue.
Who will help EWLO?
Laser obliteration will be effective in the following cases: 
- a moderate amount of varicose-modified perforating veins;
- widening of the mouth of a large vena cava no more than 1 cm;
- smooth course of large veins( bends along the main trunk will not allow the endoval entry);
- presence of trophic shin disorders.
General and local contraindications
The procedure should be performed only after a complete examination of the patient, since there are a number of pathologies that are contraindicated for laser therapy:
- presence of thrombophilia increases the likelihood of developing PE and thrombotic process in the venous system;
- chronic lower limb ischemia - use of a bandage in the postoperative period will aggravate the degree of ischemia;
- general diseases requiring first-line therapy ;
- obesity , not allowing to create the necessary compression after the procedure;
- the patient can not conduct an active image in the postoperative period , it is better to replace obliteration with stripping;
- inflammatory processes in the area of intervention can trigger infection;
- enlargement of the mouth of the large vena cava more than 1.5 cm ( cases more than 1.8 cm are known).
Preparatory stage
The patient does not need special preparation. It is necessary to undergo a complete examination. In the morning before the procedure should be shaved lower limb.
With the help of ultrasound, the area of intervention is marked out. The first label is placed on the lower border of the reflux on the hollow vein. In the second area, a puncture will be performed, it is located 3 cm distally.
Further along the course of the vessel, the places where the tributaries flow fall. In these zones it will be necessary to conduct a long-term laser exposure to "close" the mouth. Also, all varicose inflows are marked, even if their removal will not be through obliteration.
Procedure of
Vascular surgeons note that the effectiveness of the intervention is based on the strict implementation of the following steps:
- puncture and insertion of the catheter into the vessel is performed by scanning, a fiber is conducted through the catheter into the lumen of the varicose vein;
- light guide is installed in the working area;
- local anesthesia along the vein involved in coagulation, will not only anesthetize the area, but also protect nearby tissues from exposure to high temperatures;
- holding EVLO, gradually removing the light guide outside;
- use of a special bandage, which reduces the risk of complications, the patient must walk for 30 minutes;
- imposed bandage is left for several days;
- the next day, sclerotherapy of varicose inflows.
Postoperative period
Soreness that occurs after the intervention is manifested as aching and pulling sensations along the vein. To stop the manifestations, non-steroidal anti-inflammatory drugs( Movalis, Ibuprofen, Nimesil, Diclofenac) are used. There may be a brief rise in temperature to subfebrile indicators.
The next day after EVOLO, the patient can start working. You can remove the bandage only when the specialist allows it. Every day you should give time to walk( about 2 hours).
Training in gyms, heavy physical exertion, visiting a bath or solarium should be postponed for several weeks. It is recommended to abandon the use of alcohol, women - from shoes with heels.
Possible complications of
After the procedure, the formation of pigmentation along the vein is possible. This condition does not require additional therapy. It can last up to six months, after which it disappears on its own.
Inflammatory reactions may develop along the course of the influxes of the vessel. The patient is prescribed the use of NSAIDs. Possible development of thrombotic complications, however, they can be prevented by following all the advice and instructions of a specialist in the postoperative period.
From the practice of the procedure
Reviews of two patients who underwent endovasal laser obliteration of veins.
I had a problem with varicose for a long time. Phlebologists advised to wear compression underwear, give up heels, go swimming. Six months ago I went back to the clinic. By results of US have advised to make EVLO.A week before the operation, she underwent the necessary examination and received a referral.
The intervention lasted 35 minutes. Feels - almost painless. On the feet immediately put on compression stockings and let go for a walk. Then you can go home. After 9 days I did the same on the second leg. A month later I was examined, the doctor said that the results are excellent. Quite expensive, but I was satisfied.
Anna( Russia, Moscow)
A friend of mine made a routine operation to remove varicose veins. Having looked, I too went to a consultation. I went to a private medical center. After a complete examination, I was offered vasoconstriction, however, this procedure is not cheap, so for another month my husband and I wondered whether to agree.
The operation took 1.5 hours. The doctor said he was suffering with me. Then the leg was wrapped in an elastic bandage, put on a stocking and sent for a walk. The first day of the leg ached, but tolerable. She refused painkillers. If to compare with the usual removal, and this is 10 days in the hospital and still at home for 2 weeks, then it turns out even economically profitable. I chose a laser and did not regret it. In a month I am going to treat my second leg.
Marina( Russia, Krasnodar)
The cost of the procedure in the Russian Federation
The money question is crucial for most patients. Price EVOLO depends on the following factors:
In the photo, the result of the application of EVLO - the money issue is of secondary importance
- the length of the "sick" vein;
- degree of disease;
- price of anesthesia;
- length of stay in the hospital.
This adds to the payment of the work of medical personnel, the cost of equipment, medicines and bandaging material. The approximate cost of treatment of one limb in Russia, depending on the city, ranges from 520 to 660 euros.
The choice of method of treatment remains with the patient. After weighing all the pros and cons, most patients choose endovasal laser obliteration of the veins.