Laser removal of veins in the legs with varicose veins. How is the operation, the postoperative period, rehabilitation, consequences, complications

According to medical statistics, in USA about 20% of men and more than 40% of women suffer from varicose veins. A barely noticeable mesh on the skin is replaced by subcutaneous nodes, which periodically swell and hurt.

One of the advanced modern methods of treating a disease in a severe stage is laser removal of veins on the legs. This is one of the most reliable and less traumatic methods that can cope with varicose veins completely.

When can’t you do without an operation

Varicose veins are changes in the walls of the venous vessels, which are irreversible, negatively affecting the flow of blood to many vital organs of a person. Typically, the diagnosis uses the classification of stages developed by the famous phlebologist Soloviev V.S.

According to her, in the disease, 4 stages can be observed:

• Stage I – compensation. At this stage, external symptoms are almost completely absent, however, venous vessels are already subject to increased stress. One of the manifestations of the initial stage of varicose veins is fatigue, swelling of the legs at the end of the day, periodic cramps.
• Stage II – subcompensation. The pathological process is gaining momentum, and symptoms such as spider veins, skin itching, severe swelling, which suffer not only in the evenings, but also in the afternoon, are manifested.
• Stage III – decompensation. The process of transition of varicose veins to the third stage takes very little time. Swelling by that time is already permanent, the skin changes color, itching intensifies, trophic ulcers appear. Complications in the form of thrombophlebitis and deep vein thrombosis are frequent.
• Stage IV – an extreme degree of venous insufficiency. With it, ulcers cover a large area of the skin of the legs, the veins expand and act as “clusters”. Abnormalities in the work of the heart are observed, and the patient requires urgent hospitalization and emergency treatment.

Laser removal of veins on the legs is recommended at the initial stage, when the veins have a clearance of not more than 0’4 inch, and the first trophic changes are observed in the skin area. However, this procedure is often used for more severe stages of varicose veins.

Laser treatment for varicose veins in the legs

The essence of the laser vein removal procedure (laser coagulation) is the principle of sealing. The laser “glues” or “seals” a diseased venous or capillary vessel, thus destroying its structure and removing it from the general blood flow system. The method almost does not involve injuries to the skin and muscle tissue (incisions) and in an outpatient setting it takes only 30-40 minutes.

Conventionally, laser coagulation can be divided into 2 stages:

• Laser action on a subcutaneous venous vessel, with valve dysfunctions.
• Impact on the tributaries of the main venous vessels, which are the cause of the “mutilated” legs.

At the end of the coagulation procedure, blood circulation passes only through healthy veins, and the patient already in a day feels significant relief.

In most cases, women after 40 years of age suffer from varicose veins. Along with the consequences, they are worried about the unaesthetic appearance of their own legs, which they are forced to hide under trousers and long clothes. The ability to quickly solve the problem and restore the appearance with minimal risk is one of the main advantages of the method.

Laser treatment for varicose veins

Laser leg vein removal is in demand due to the many benefits of coagulation.

These include:

• Lack of surgical intervention, which means large incisions, scars and scars, which is typical for surgery. Also, after the procedure, there are no bruises or bruises.
• Local anesthesia is much more sparing than general. Moreover, it makes the procedure completely painless. The patient does not feel any discomfort.
• The rehabilitation period is not more than a week. It does not provide for a pastel regime and minimizes the daily activities of the patient.

• Each stage of the operation is carefully monitored, which guarantees complete safety of the entire procedure as a whole.
• According to statistics, 98% of patients recover completely after surgery without consequences and relapses.
• The absence of side effects is also an indisputable advantage of the laser coagulation method.
• The laser removal method guarantees not only a complete solution to the varicose veins problem, but also makes it possible to feel the result of the procedure the very next day after the operation.

Disadvantages compared to other methods

Laser coagulation, like any type of medical intervention, has several disadvantages. However, the advantages of the procedure far outweigh its “cons”. The disadvantages include complications, which in rare cases have been reported in patients.

Among them are:

• Temporary disorder of sensitivity of the lower limb.
• In rare cases, hematomas or bleeding. Most often this happens due to the small experience of a specialist with equipment.
• Thrombophlebitis, the spread of infections and phlebitis. This result most often happens when the patient is predisposed to blood clots and low immunity.

• Slight pigmentation of some areas of the skin.
• Light pain arising from hypersensitivity or poor-quality anesthesia.

Sometimes there was hyperthermia, vein tension, passing within 20-30 days. Also, experts recommend abandoning tanning and tanning beds within a month after the operation.

Features of Laser Vein Removal

During the laser coagulation procedure, 2 types of exposure are used. Each of them has its own advantages and disadvantages. Only a phlebologist can determine the best method and recommend it to the patient based on preliminary examination data and analysis results.

Endovasal Laser Coagulation (EVLK)

EVLK is a contact method in which there is a thermal effect on the cells of the inner surface of venous ve
ssels. At the time of application of the laser, the process of blood thickening and the formation of vapor bubbles in it begins, as a result of which a thrombus forms, which sticks together, and then finally “seals” the vessel.

Indications for the use of this method are:

• vessel lumen less than 13/32 inch;
• smooth running of the saphenous vein;
• a small number of processed veins.

Percutaneous laser coagulation

With this method, there is no direct contact with the vein. However, the walls of the venous vessels warm up to 44,6 – 32°F, as a result of which the adhesion of the walls of the veins occurs. The use of this method does not require long preliminary preparation.

Indications for the procedure are:

• vein clearance less than 4/32 inch;
• the presence of spider veins on the skin.

In rare cases, side effects are observed in the form of edema or a change in skin tone to a lighter (almost white). But this passes over time.

Indications

The decision on the appointment and conduct of the laser coagulation procedure is made only by a phlebologist.

The main indications are:

• varicose veins with a lumen of less than 13/32 inch;
• the presence of spider veins;

• disturbances in the process of cellular nutrition in the lower leg;
• dilated inflows of the main veins.

In any case, to make a final decision, a specialist should familiarize themselves with the results of a full examination.

Contraindications

Laser removal of veins on the legs can harm the patient’s health in some cases. These contraindications can be divided into absolute and relative.

Absolute contraindications include:

• thrombophlebitis and the tendency of the body to form blood clots;
• a high degree of damage to the walls of venous vessels;
• chronic nature of circulatory disorders in the lower extremities.

During the procedure under these conditions, the probability of massive thrombosis is high.

Among the relative indications are:

• inflammatory processes in the area of the skin;
• relapse of chronic diseases;
• high degree of obesity;
• atherosclerosis;

• pregnancy and lactation;
• heart disease;
• the inability to use compression underwear during the rehabilitation period.

Laser classifications for surgery

Laser removal of large veins in the legs involves the use of EVLK. To work with capillaries located near the surface of the skin layer, other 2 types of lasers are used: neodymium and diode.

Features:

• A diode laser is used to remove small capillaries with a gap of up to 2/32 – 3/32 inch. For the greatest effect, it is necessary to conduct 3-4 sessions with breaks between procedures not exceeding 4 weeks.

• A neodymium laser is used to eliminate spider veins and veins with a clearance of up to 4/32 inch. A smaller number of sessions is required here – from 2 to 4, with a break of 3-6 months, depending on the individual characteristics of the patient. For anesthesia, local anesthesia or anesthetic creams are used before the procedure.

Preparing for the operation. Analyzes and preliminary examination

Preparation for surgery includes a medical history and evaluation of the results of clinical trials. In the course of the anamnesis, the phlebologist identifies the causes and symptoms of the disease, sets the approximate period of its course. It is also mandatory to determine what conservative treatment the patient underwent before a decision was made about the operation.

Clinical trials to be completed include:

• ultrasound of venous vessels;

• Analysis of urine;
• blood coagulation test, RW, as well as a general biochemical analysis.

On the evening before the procedure, a cleansing enema is prescribed. On the day of laser coagulation, do not eat or drink.

Stages of the operation

Laser surgery to remove leg veins involves the following steps:

1. Anesthesia. Local anesthesia is enough to remove all pain. In some cases, a sedative is recommended to the patient. Spinal anesthesia is used very rarely, only in exceptional cases.
2. Treatment of the skin area with a disinfectant.
3. Insertion of a fiber into a damaged vein. For this, a micro incision is made in 4/32 – 6/32 inch. The movement of the fiber in the vessel is controlled by an ultrasonic device.
4. Heat exposure. As a result of this, vessel adhesion and cauterization of channels occur.

With percutaneous coagulation, the first two stages are identical, but instead of a puncture, the thermal effect on the skin is used, as a result of which a small burn remains, which passes over time.

Such an operation lasts from 40 to 90 minutes, depending on the area of the lesion. After this, the
patient is in the clinic for another 3-4 hours and is sent home the same day. After 3 days, a postoperative examination of the patient is carried out in order to determine the healing rate and recovery after the procedure.

Postoperative period

Immediately after coagulation, the patient wears compression garments, which are recommended to be worn for the next 1.5-2 months.

To achieve the result, the patient must:

• constantly wear compression underwear;
• make daily walks of at least 3 hours;
• eat healthy food.

Daily walks contribute to the saturation of blood with oxygen, which positively affects the tone of the venous vessels. In addition, the resulting moderate physical activity allows you to “disperse” the blood, contributing to a more rapid recovery of the body after surgery.

The patient should not:

• smoke and drink alcohol;
• wear uncomfortable shoes or high-heeled shoes;

• subjected to strong physical exertion;
• take drugs that affect vascular elasticity;
• visit the bathhouse, sauna, solarium;
• sunbathing in the sun.

Effects

Like any medical procedure, laser coagulation has a number of consequences for the patient’s body and well-being.

After the procedure, the patient may experience:

• slight pain and bruising at the puncture site or burn site;
• a slight increase in body temperature;
• temporary violation of sensitivity due to the use of anesthesia;
• sensation of tension of venous vessels.

All these unpleasant symptoms are the result of the operation and pass quickly enough. However, in the case of a prolonged nature of the consequences, it is necessary to consult a specialist.

Possible complications

More serious complications are very rare and are expressed in the following symptoms:

• worsening pain in puncture sites;
• inflammation and proliferation of purulent foci at puncture sites with EVLK;
• the appearance of uncharacteristic skin pigmentation;
• muscle pain when walking;
• swelling of the legs.

All these are indirect signs of a disease such as venous thrombosis. In this case, you must immediately consult a doctor.

Compression underwear

Compression underwear is recommended to be worn for the first 5 days of the rehabilitation period around the clock. Then you can go only to daytime wearing for 1.5-2 months.

The standard types of compression underwear for varicose veins are:

• tights;
• stockings;
• knee socks.

In some cases, an elastic bandage is used. It is because of the need to use compression underwear that doctors recommend performing the operation in the cold season, when wearing it does not cause much discomfort.

Where to do the operation and approximate prices

When choosing a clinic for the operation, it is necessary to pay attention not only to the price factor, but also to the equipment, qualifications and experience of specialists. The latest equipment guarantees not only the success of the coagulation session, but also the minimum discomfort that the patient will have to experience.

It is worth paying attention to whether there are other methods of treating the disease in the clinic. According to most experts on the vessels and circulatory system of a person, the treatment of varicose veins should be comprehensive. Therefore, a one-sided approach by professional phlebologists is not welcome.

Prices for this service vary not only from clinic to clinic, but also from the center to the.

The average cost of the procedure in New York is $ 408 – $ 816, excluding the cost of consulting a phlebologist and all clinical trials. In some clinics, the price bar reaches 80000, but this is more likely an exception to the rule.

In the, the transaction price is lower – $ 340 – $ 544. However, when performing an operation in aal clinic, special attention must be paid to the equipment used. The best option is a specialized clinic, where the main profile is precisely the fight against varicose veins.

Also of great importance is the number of operations performed, patient reviews and the period of stay and work of a medical institution in this segment.

The procedure for laser removal of veins on the legs can be a real salvation for people suffering from varicose veins. Painlessness, minimal injuries and the ability to move almost immediately after the session are the undeniable advantages of the method. For this reason, laser coagulation is such a popular and popular operation.

Video about laser leg vein removal

The principle of laser vein removal:

What the legs look like 10 days after surgery: