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Endovenous laser ablation (EVLA)

Endovenous laser ablation (EVLA)
EVLA is an excellent solution for the treatment of varicose veins: excellent medical and cosmetic results, minimum risk of complications, performed under local anesthesia, stay in the clinic for about 3 hours.

Today, probably, everyone who has decided to get rid of varicose veins has already heard about the "magic" procedure - "LASER" !!!


Let's try to clarify - the term "laser" hides just one of the methods of surgical treatment. Yes, it's an operation. But this is an operation that is fundamentally different from the usual removal of veins without incisions.


What is a "laser" operation?


The whole essence of this method is clear from the full name, but it is lost behind a pile of medical terms. We will help you translate.


"Endovenous" means that the effect on the vein is from the inside, i.e. a surgical instrument, namely a light guide, is located in the lumen of the vein. The easiest way is with the definition of "laser" - i.e. the impact is made with the help of high-energy coherent radiation (laser), which is delivered to the lumen of the vein through a fiber. "Coagulation" is a term for tissue destruction. In other words, with the help of high-energy laser radiation, a controlled burn of the venous wall is produced, as a result of which it is "welded", as it were.


This is not dangerous?

Anyone who says surgery is completely safe is a brazen liar.


Endovenous laser coagulation is a surgical procedure.

Yes, less traumatic.
Yes, well controlled at every stage.
But, nevertheless, surgical intervention.
Fortunately, due to the control of each of the stages of the intervention using ultrasound, the risk of complications is several times lower than with open operations, and these complications are much less severe. Unfortunately, doctors are unable to predict the future. We can only assess the clinical situation and choose the safest method. Today, laser operations are the safest.

It does not hurt?

If you are able to withstand an intramuscular injection, then you can quite imagine the level of pain associated with this operation. Indeed, all painful sensations are caused by the injections necessary to insert a catheter into a vein and inject an anesthetic.


Of course, the pain threshold is different for everyone, and for some even injections seem very painful, but most patients tolerate these sensations quite easily.


And what, after the laser, everything will go away right away?

No, not right away. A laser is a specialized surgical instrument designed to eliminate the trunk and large saphenous veins. It is through them that blood is released under high pressure, which leads to the expansion of the saphenous veins on the lower leg and thigh.


Those. with laser surgery, we eliminate the cause. Most often, those varicose veins are the result of increased pressure in the main saphenous veins. As a result, after eliminating the cause of the increased pressure, the dilated veins decrease in size.


Complaints about unpleasant physical sensations, such as heaviness, convulsions, edema, disappear almost immediately after the operation, but the dilated veins return to their original appearance within 2-3 months. If varicose veins have existed for a long time, then as a result of the changes that have occurred, the saphenous veins on the lower leg may not completely disappear, but at the same time they decrease so much that they can be eliminated with the help of sclerotherapy or miniflebectomy.


Can any varicose veins be eliminated with a laser?

No, not everyone. As with any surgical technique, laser coagulation has its own technical and anatomical limitations. It is possible to determine the possibility of using EVLK only after a thorough ultrasound examination with the identification of the causes of venous discharge, overflow pathways and taking into account anatomical features. However, with varicose veins, laser coagulation is applicable in about 90-95% of cases of primary surgical treatment.


How is the operation going?

The patient comes to the clinic with the results of the examinations, the medical documentation is drawn up, the doctor once again explains the procedure, indications and contraindications, possible complications, takes consent to the intervention. After that, the patient is taken to the operating room, where the doctor once again performs an ultrasound examination, marks the dilated veins, determines their diameter to calculate the radiation energy. Drugs are administered to reduce pain and prevent thrombotic complications.


Then the patient is placed on the operating table and under local anesthesia under the control of ultrasound, a light guide is inserted through the needle into the dilated vein. All the same, under ultrasound control, the light guide is carried out to the failed valve. Then, everything is also under control, anesthesia is performed around the vein, after which the laser radiation is turned on and the doctor slowly removes the light guide, gradually brewing the altered vein along its entire length. Then a pressure bandage is applied to the intervention area and compression hosiery is put on. After that, the patient goes home on his own.


Is there any kind of postoperative observation needed?

As a rule, surveillance is not needed anytime soon. During the evening after surgery, the dressings may become slightly wet with anesthetic. Taking analgesics after surgery is not required in 90% of cases. The next day, an examination and control ultrasound is required. Repeated ultrasound to assess the effectiveness is performed one week and one month after the operation.


Are there any restrictions after the surgery?

We strongly discourage patients from driving for surgery. This is due to the use of local anesthesia and can reduce the sensitivity and reaction rate of the operated leg, which can be unsafe for road traffic.


After the operation, you must:

  • wearing compression hosiery continuously for the first day
  • then, we strongly recommend wearing the jersey throughout the day for 2 weeks.
  • it is also strongly recommended to refrain from drinking alcohol in the immediate postoperative period and limit visits to the bath / sauna / solarium, as well as exposure to the sun.

How will the blood flow if large veins are welded / removed?

It will flow in exactly the same ways, only better.


The fact is that there is no normal outflow of blood through the varicose veins. Quite the opposite - the blood through them most of the time (at least when you are sitting or standing) flows in the opposite direction, leading to overloading of the underlying sections and stagnation. Therefore, turning off the already inactive veins does not lead to any problems, because to this path of the main outflow of blood have already become different.

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