All about laser methods for the treatment of varicose veins of the lower extremities

Varicose veins in the legs are an ailment that affects about 40% of women and 20% of men, regardless of age. Treatment of veins affected by varicose veins includes a whole range of different means and techniques, including surgical intervention of varying degrees of complexity.

laser treatment of varicose veins

Treatment of varicose veins with a laser has become widespread in modern vascular surgery. And this is not surprising, because the classic surgical treatment - phlebectomy (removal of veins in the legs in whole or in part) - is a rather painful, highly traumatic and risky operation, after which a long and difficult period of rehabilitation is required.

In addition, after a classical operation to remove veins in the legs (in whole or in part), there is a risk of infection of the wound, which is also a significant disadvantage of this type of intervention.

Laser treatment of varicose veins consists in the fact that the diseased vessel, having received a dose of laser beams from the inside, sticks together and is removed from the circulatory system of the body or dissolves.

Thus, laser coagulation of veins has tangible advantages in the form of:

  • The procedure is performed in a short period of time.
  • There is almost no risk of infection.
  • relative security.
  • No need for a recovery period after surgery.

Therefore, many patients prefer the treatment of varicose veins on the legs with a laser, as the fastest, least traumatic and sparing method of anti-varicose therapy.

Methods for diagnosing varicose veins

Before recommending to the patient one or another type of surgical intervention to remove veins in the legs, the treating doctors: a therapist or phlebologist, prescribe a set of measures to diagnose the nature and degree of varicose veins of the lower extremities.

On the part of the therapist, these will most likely be referrals to the KLA and OAM, and the phlebologist may prescribe any of these research activities:

  1. Duplex ultrasound scan. Allows you to establish the dynamics of intravenous circulation and the state of the venous walls of the calves of the legs. With the help of ultrasound, the doctor detects the degree of activity of blood movement through the veins, the amplitude of blood flow, as well as those vessels, the condition of which requires laser surgery.
  2. Magnetic resonance phlebographic study. Using this method, the doctor excludes the presence of thrombotic formations. Such a study is carried out as follows: a special contrast agent is introduced into the venous vessels, which, under magnetic influence, allows you to accurately determine the vascular pattern.
angiography before laser treatment of varicose veins

Recommendations for the operation

Laser coagulation of varicose veins can be recommended for almost all patients, regardless of age and gender, if the following symptoms of varicose veins in the legs are detected:

  • Painful sensations, a burning sensation and fullness at the location of the vessels on the legs.
  • Convulsive phenomena.
  • Deformation of the veins.
  • Phlebitis of superficial veins.
  • CVI (chronic venous insufficiency).
  • capillary mesh on the surface of the skin.

In addition, the following circumstances are important determining factors for the appointment of such a type of surgical intervention as laser coagulation of varicose veins by a phlebologist:

Laser therapy is carried out only on the veins located directly under the skin itself. It can be both large and small venous vessels, only their location, close to the surface of the skin, is important.

Laser removal of veins is recommended provided that they expand by no more than 10 mm in diameter. If, as a result of varicose veins of the lower extremities, the vessels are deformed by more than 1 cm, there is a high probability of their further "unsoldering" and the resumption of venous blood flow.

Veins that can be treated with a laser should be relatively straight and not bent, and the vessels adjacent to them should not be affected by serious varicose deformity, otherwise laser surgery may be ineffective.

Treatment of varicose veins with a laser allows exposure to only limited areas of diseased vessels. "Running long distances" with laser treatment is likely to be ineffective, which can lead to ungluing of diseased veins and the resumption of blood flow inside them.

leg pain with varicose veins

Counter-recommendations for laser ablation

Thus, laser treatment of varicose veins is not recommended if deep veins are affected by the disease, and the venous lumen is expanded by more than 10 millimeters, and also if varicose veins have affected a large area of the venous vessel.

And in what other cases is it forbidden to remove varicose veins with a laser?

  • Firstly, these are already formed blood clots inside diseased veins.
  • Secondly, this is a strong destruction of the very structure of the vessels.
  • And thirdly, these are serious dysfunctions of the lymph and blood flow with varicose veins on the legs.

In addition, there are a number of contraindications to laser vein treatment surgery, which are mostly temporary, removable. These include:

  1. Damage and inflammation of the skin, including trophic ulcers, especially at the site of the diseased vessel. In the presence of an inflammatory process, the risk of postoperative infection increases, so you must first undergo a course of treatment and only then carry out surgery.
  2. Pregnancy and lactation period. The fact is that the immune systems of the body during this time period do not work at full capacity, and the amount of load on the calf region, on the contrary, is significantly increased.
  3. Obesity, overweight. In addition to the difficult accessibility to the location of the diseased vessel, in this case there is again an increased load on the calves of the legs, which can significantly complicate the process of postoperative recovery.

Types of laser treatment of blood vessels

  • Endovasal laser coagulation, when the walls of a venous vessel are glued together through the intravenous action of a laser beam on the internal vascular walls, the space between which will gradually be filled with connective tissue.
  • Removal of blood vessels by laser coagulation, carried out in order to remove spider veins on the surface of the skin without penetrating into the vessel itself. Such an intervention involves heating small (up to 3 mm in diameter) vessels with laser beams at a temperature of about 70 degrees, resulting in the disintegration of the vascular walls and the removal of the capillary network.
laser treatment for varicose veins

The method of conducting surgical intervention

Treatment of varicose veins on the legs with a laser is carried out on an outpatient basis. Since the localization of the venous vessels to be removed is usually small, and the entire intervention is performed intravenously, surgery under general anesthesia is not required, patients receive only local anesthesia.

In order to eliminate increased nervousness before the operation, the patient is often recommended to take a mild sedative drug, in this case it is desirable that one of his relatives accompany him from the hospital to the house.

The endovenous laser coagulation itself is carried out as follows.

A micro-incision is made at the location of the affected vessel, after which the light guide is inserted. Through this medical device, laser beams of various frequencies enter the vessel, with a wavelength recommended by the doctor.

After the laser radiation begins to flow, laser obliteration of the veins occurs, and the blood is gradually forced out of the vessel.

As a result of the omission of the intravascular space, the walls of the vessels adjoin closer to each other, and subsequently their almost complete adhesion and overgrowing with connective tissue occurs.

The operation for laser removal of a vein on the legs lasts, as a rule, from 20 to 40 minutes.

After laser removal of diseased parts of the veins, intravenous blood flow is distributed along deeper venous vessels located in the thickness of the muscles and not so distinguishable during examinations and palpation. In addition, after laser coagulation, there are practically no wounds, scars and cyanosis on the skin surface.

varicose veins and its laser treatment

Postoperative period

Rehabilitation, consisting of postoperative therapy, taking a course of anti-inflammatory drugs, bed rest, after such an intervention as laser treatment, is not required, the patient can get up and go home almost immediately.

However, after a long stay in the supine position during the operation to remove the veins on the legs, patients are recommended to somewhat slow down the process of getting up from the operating chair.

That is, you first need to take a sitting position and spend some time in it so that the intravenous blood flow returns to normal.

And only then you can get up and go to the exit. Patients, as a rule, do not experience pain, only a slight tingling effect is possible at the location of the removed vessels. Thus, painkillers are also not needed!

An important point in the postoperative period is the need to constantly wear therapeutic compression underwear: golf, tights, stockings, the compression class of which will also be recommended by the attending physician.

As a rule, such underwear should be worn for a long period, up to 50-60 days in a row, and in the first two days it is forbidden to take it off even at night.

Due to the compression effect, such underwear will ensure an even distribution of blood flows inside the vessels of the leg, which will eliminate swelling and other unpleasant symptoms of varicose veins.

As the operated veins fill with connective tissue, and blood flows are distributed to deeper, healthy vessels, the need for underwear will gradually disappear.

Sick leave for patients who have undergone laser surgery, as a rule, is not issued if the work activity is not associated with constant tension in the calf region, prolonged standing or lifting weights.

If these moments are absent, the patient can return to the workplace the next day.

And also immediately after the operation, it is recommended to take a 20-30 minute leisurely walk on a flat road surface, after putting on compression underwear.

Different people have their own perception of the procedure, watch the video where the girl tells how her operation went.

Conclusion

Treatment of varicose veins with a laser is the most preferred, modern and painless method of intervention, available to almost every patient.

However, in addition to surgeons, the patients themselves should help themselves in getting rid of varicose veins.

So, you should include in your daily routine a course of therapeutic exercises recommended for varicose patients, give up alcoholic beverages and smoking, and avoid excessively salty, spicy and smoked foods.

Baths and saunas should also be prohibited, especially in the first time after the operation.

In addition, if professional activity is associated with constant standing on one's feet or vice versa, a long stay near the computer, it is necessary to periodically interrupt for a relaxing rest or a short walk.

Watch the condition of your legs, do not start the development of varicose veins! Remember - our health is in our hands!

12.03.2022