Treatment of varicose veins by laser: varicose veins, coagulation, the operation

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The varicose disease is a disease which occurs destruction of the valve of the device of the veins of the lower extremities, which causes a blood flow, the veins gradually dilate.

First of all this is pure cosmetic defects, but with the progression of the disease occur and the clinical symptoms until-threatening complications – phlebitis, and embolism.

Given that the mechanism of varicose veins even in the dissection of a default, conservative treatments here are ineffective. Despite the tragedy of the advertising funds from this disease, the drugs may not be considered as a means of prevention of the progression of the disease at the initial stage.

Logically, the most radical method of treatment of this pathology is surgery. The aim of the operation was to eliminate him-advanced to the track. This is achieved or the removal of varicose veins or its obliteration of the.

Until recently, the most common operation for varicose veins was the stripping and phlebectomy, it is the complete deletion of the untenable vienna, quite traumatic and unpleasant procedure, performed under general anesthesia, after which remain scars and sustainable do not pass hematoma.

Over the past decades in the practices of adoption and other methods of surgical treatment of the varicose disease: electrocoagulation, sclerotherapy, radiofrequency ablation, and others. However, all the proposals of the minimally invasive techniques of the greatest popularity was received by the method of laser coagulation of the vein.

The advantages of laser coagulation of varicose veins

Laser Photocoagulation veins for the first time has been applied to a little over 10 years. To date, this procedure is the main method of treatment of varicose disease abroad, each day his popularity in Russia. This operation is constantly improved.

The main advantages of laser coagulation of varicose veins:

• Instead of several incisions made with a needle. After the operation, there are no remaining bruising under the skin.
• It is not necessary in general sedation or anesthesia.
• The indolence. The operation is done under local anesthesia, the patient feels no pain quite of notes or a mild discomfort.
• The ability to perform operations in an outpatient setting, hospitalization is not necessary.
• The absence of the need for a lengthy rehabilitation. After 1.5-2 hours after the procedure, you can return to its normal mode. The ability to work is not broken.
• The lowest percentage of complications compared to other methods.
• The opportunity of the operation when there is venous ulcers.
• Laser coagulation can be repeated several times.

The essence of treatment of varicose veins laser

The indications for the procedure is the varicose veins of varicose veins. The most frequently suggested laser treatment for the extensions of venous tributaries.

Do not apply a treatment during the expansion of the saphenous vein more than 10 mm in diameter, and so highly convoluted scope of vienna. In these cases, this procedure would be inefficient technically impossible.

When the presence of a multitude of varicose veins extensive tributaries, you must also delete them. The laser treatment in such a case, it is economically impractical (this method is quite costly).

The laser treatment of varicose veins – the method is quite young, therefore, the development and improvement of its continues. Debate about optimal laser power, develops and implements new approaches.

The essence of the method of laser coagulation lies in the fact that the impact of the energy of the laser leads to the "boiling" of the blood in the vessel, high temperature acts on the inner wall of the vein, thermal burn, and the gluing of the wall of the vein with obliteration of the his light.

Eliminated anatomical substrate of the disease-varicose – extension of the vienna disappears and transforms into connective tissue tyazh (or simply maul), which is not visible under the skin. In addition, it is, generally, full resorption of vienna.

How is the procedure

In the classic version of laser treatment eliminates any incisions.

• Under the control of ULTRASOUND in the vertical position is marked vienna at laser erase: the projection of the just is drawn in marker pen on the skin. Stand out as well its tributaries.
• By a small puncture (after pre-local anesthesia) is done as puncture of the vein special vein with a catheter. In fact, the bite of anesthesia before the puncture is the only feeling sickly during this operation.
• Through the catheter the laser and the light. Under ultrasound control skylight pass to the area of vienna.
• Performed tumescent anaesthesia infiltration around the modified vienna combined with a solution containing an anesthetic, lidocaine, epinephrine, and physical solution. This infiltration not only provides anesthesia, but protects the surrounding tissue of the burn.
• Then carried out the procedure itself – turns on the laser light and the product of the inverse of the traction of the tip with 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 the diameter of the vein and the wavelength of the laser radiation).
• Varicose veins advanced tributaries are cleaned by micro-perforations.
• After the procedure, is superimposed a strip of compression (special latex rolls over the city of vienna, attach themselves to the skin glue) and compression stockings (II) the degree of compression.

The stockings are bought in advance, know advise the doctor prior consultation.

The main contraindications are:

• The inflammatory changes of the skin and subcutaneous tissue in place of the planned procedure.
• The diameter of the vein more than 1 see
• Violation of function of walking because of other diseases (osteoarthritis, effects of a stroke, other diseases of the lower limbs).
• Infectious diseases or decompensation of chronic diseases somatic diseases.
• The various diseases of the arteries of the lower limbs. When these diseases disrupted the blood circulation of the legs, and the laser treatment can aggravate the situation.
• The increase in the number of platelets in the blood (increases the risk of formation of thrombi).
• Repeated thromboses in the story.
• Pregnancy and breast-feeding.
• Obesity is to a high degree, because it makes it difficult for the necessary post-operative compression.

Preparation for treatment lasers

Before the operation, you will have to undergo a review. Usually assigned to a standard set of analyses:

• The general analysis of blood, urine.
• The biochemical analysis.
• The study of the coagulation of the blood.
• The blood on markers of a hepatitis, HIV, syphilis.
• The ECG.
• Fluorographie.
• The inspection of a therapist.
• The gynecologist for the women.

With the exception of a survey standard necessarily performed an ultrasound of the vessels of the legs.

To advance knowledge and support stockings. They are selected individually by the doctor. Usually, you can buy them in the same clinic, where it is intended for the operation of or in a salon.

Before the surgery, the need to shave the legs.

The postoperative period

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

• At the end of 2-3 days to a control of a physician is obligatory ultrasound in the study.
• If need an operation on the other leg, it is assigned at least one week.
• Compression is not removed within a period of five days, and then during 1,5-2 months, dressed only in a day. In this regard is not recommended to conduct operations in the hot time of the year.
• It is recommended daily of brisk walking at least 1 hour.
• A little bit of time on the site is not good in vienna and in the places of the perforations are saved bruising, and pigmentation.
• For several weeks, it is necessary to avoid long static loads on the foot, prolonged sitting, to visit the baths and saunas, hot baths.

The possible consequences and complications of laser

The procedure causes inflammation and aseptic necrosis of vienna.

As a result, the following may occur:

• A slight pain in the member in a period of 2-3 days.
• Sensation of tension in the course of vienna, discomfort during flexion-extension.
• A brief rise of temperature to low-grade fever figures.
• The appearance of hematomas.

All of these unpleasant symptoms for a short time and disappear after a few days.

It is also worth mentioning the possibility of a relapse of the disease : the lack of obliteration of the lumen of the vein that leads to the recovery of the blood circulation and develop. Most often it is the absence of recommendations, post-operative.

Very rarely, you may experience more serious complications – thrombophlebitis coagulated vienna or deep venous thrombosis. These complications occur in 4 – 6 days after the operation, it is necessary to remember the risks and the symptoms, in which you must consult your doctor immediately:

• The appearance of a strong pain in the leg.
• Elevation of the temperature above 38 degrees.
• The appearance of redness, tightness, pain on the road to vienna.
• The appearance of edema of the leg.

The main disadvantage of the elimination laser for varicose veins is the cost. This transaction is for a fee. The cost of the operation – from 500 to 1000 dollars.

The price mainly depends on the amount of the transaction (takes into account the length of the vein, the deletion and the number of its tributaries), the equipment used (laser radial is more expensive).

The price of compression is also not small, and save on this is not worth it.

However, the comments of patients who have undergone laser obliteration of the veins in the vast majority positive.

Without anesthesia, without the slightest pain! At the end of 40 minutes after the operation, you can walk, after 2 hours, you can go home and return to their usual activity.

The effect is visible after a few days: neither pain, nor swelling, or bulging sling under the skin. Point of view of patients: laser surgery is money.