Indications for treatment of venous insufficiency of the lower extremities by intravascular laser

The article was professionally consulted by Specialist Doctor II Nguyen Quoc Viet - Interventional Cardiologist - Department of Examination & Internal Medicine - Vinmec Danang International Hospital

Varicose veins of the lower extremities, also known simply as varicose veins of the legs, is a phenomenon where the function of the lower extremity venous system to return blood to the heart is impaired. This leads to stagnation of blood, causing dangerous changes in hemodynamics and some deformation of surrounding tissue.
1.1 Risk factors According to Dr. Nguyen Trung Anh, currently Deputy Director of the Central Geriatric Hospital, about 25% - 35% of the population suffers from venous insufficiency of the lower extremities. This disease often has a number of risk factors such as:
Age: studies show that the incidence of varicose veins increases with age; Overweight - obesity; Genetic factors; Gender: the disease occurs in women with a higher frequency than in men; Jobs that require workers to sit for a long time or stand for a long time... 1.2 Signs of varicose veins in the lower extremities Doctors said that in the early stages of the disease, it will be difficult for patients to detect the disease through through symptoms. However, the disease can have some manifestations such as:
Leg pain and fatigue, feeling heavy in the legs; When standing for a long time or sitting a lot, the legs show signs of sitting a lot; Night cramps and often a stinging sensation in the lower leg...

The principle of treatment of varicose veins in the lower extremities with Intravenous Laser is to release a sufficient amount of energy to the venous lumen, thereby destroying the vein by irreversible physiological reactions. More specifically, the laser light will shrink the varicose veins, preventing blood from flowing through.
Intravascular laser method was first used to treat superficial varicose veins under the skin in 1989 with a wavelength of 1064mm. Towards the end of the 20th century - the beginning of the 21st century, many other studies have been published proving the ability to treat chronic lower extremity venous insufficiency with intravenous laser with an efficiency of up to 97% - 100%.
Currently, endovascular laser treatment for chronic varicose veins of the lower extremities has been widely applied in many countries around the world. In about 6 months after the treatment, the vein area burned with laser will completely atrophy or shrink like a loofah.
Patients after endovascular laser treatment will gradually no longer have symptoms of the disease. This is a method with high safety and minimal invasiveness, thereby promoting the fast recovery process, leaving no scars.

Patients will be indicated for endovascular laser treatment when:
Patients with lower extremity venous insufficiency show symptoms, clinically classified according to CEAP from C2 to C6; Occurrence of venous reflux on Doppler ultrasound; Medical treatments are not effective. However, endovascular laser also has some absolute contraindications, including:
Patient has no or complete loss of the ability to walk; Pregnant women; Venous thrombosis forms deep in the lower extremities. In addition, some relative contraindications include:
Patients with allergies; The size of the vein is too large (over 12mm) or too small (less than 3mm); Veins with excessive twisting or kinking / segmental aneurysms.

To ensure the safety and speed of recovery for the patient is the highest, it should be noted:
Can be discharged the same day, but the patient should stay in the ward for about 4 hours to prevent complications may appear; Painkillers, anti-inflammatory drugs, anti-edema drugs can be used in case of need; The patient needs to be able to walk slowly. During rest, keep your feet elevated and do not remove socks for 72 hours after surgery; Within 5 days, the patient was not allowed to exercise vigorously. When to go to the hospital?
The patient needs to see a doctor as soon as the following abnormalities appear:
The pain is severe and persistent; Stiffness, swelling of the leg suddenly occurs or there is inflammation and redness in the path of the treated vein; Shortness of breath, chest tightness; Hematoma or bleeding at the puncture site when endovascular laser is performed. Possible complications when treating lower extremity venous insufficiency with endovascular laser
Thrombosis capable of causing pulmonary embolism: the patient must be hospitalized for monitoring and anticoagulation treatment; Superficial thrombophlebitis: treatment towards pain relief - reduce inflammation; Injury to neighboring nerves: monitor and prescribe pain relievers - anti-inflammatory drugs; Skin necrosis: treatment with antibiotics, anti-inflammatory drugs, skin grafting can be considered and combined with additional care therapy; Bleeding and hematoma: dressing change and local compression. The effectiveness of the treatment of chronic lower extremity venous insufficiency by endovascular laser is very high, reaching 100% if the patient responds well and carefully follows the care instructions from the doctor. Therefore, this is good news for anyone who is facing this problem.
Currently, Vinmec International General Hospital is providing lower extremity venous insufficiency examination package to help patients determine the causes, complications and level of venous insufficiency, thereby taking timely intervention measures. .