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    Scientists Identified Several Complications In Endovenous Laser Varicose Vein Surgery

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    Scientists at the Surgut State University (SurGU) together with a group of phlebology centres have analysed the endovenous laser treatment and revealed several postoperative complications, including those due to surgical errors.

    The results of the study were published in the prestigious international journal International Angiology.

    The endovenous laser ablation (EVLA) is a modern method of treatment of varicose veins with low traumatism. The laser gently warms up the vein walls to 85-90 ℃, resulting in the vein “wrinkling” and dissolving.

    Laser intervention is performed through a puncture of the skin under local anaesthesia. Immediately after the operation, the patient can be released home. Due to this combination of minimal traumatism and outpatient treatment, endovenous laser ablation has become a new standard of varicose vein treatment in almost all developed countries.

    A scientific group from the Surgut State University and one of the phlebology centres have studied the results of laser varicose vein treatment and found out that two groups can be distinguished in the structure of complications after endovenous laser ablation.

    “The first group is deterministic (complications arising due to the mistakes of the surgeon during the intervention), the second group is stochastic (random and impossible to prevent complications in a particular patient)”, a professor of the department of surgical diseases of the medical institute at Surgut State University, Konstantin Mazaishvili said.

    According to scientists, the most common deterministic complications are the fragmentations of the laser fibre and hyperpigmentation (0.14% each), the rarest are skin burns (0.07%) and allergic reactions to local anaesthetic (lidocaine).

    Among stochastic complications, the most common are deep vein thrombosis of the lower limbs (1.55%), pain syndrome (1.41%) and paraesthesia (1%). The rarest stochastic complications are pulmonary embolism (0.07%) and abscess in the coagulated vein (0.07%). Arteriovenous fistulas in the area of laser ablation are rare.

    The reason for the development of deterministic complications was inadequate selection of laser radiation parameters and large-diameter veins, laser ablation of superficial veins, inadequate ultrasound guidance during interventions, insufficient volume of local anaesthesia, insufficient heating of the vein due to equipment problems, damage to the optical fibre and leaving its fragments in the coagulated venous vessel lumen.

    As Mazaishvili noted, complications in the endovenous laser treatment are almost 10 times less common than after traditional surgery (ambulatory phlebectomy), but their nature is not fundamentally different from other vessel intervention surgeries.

    According to researchers, diagnosis, treatment and prevention of complications should include follow-up medical check-ups in the early postoperative period with mandatory ultrasound examination, wearing of Class 2 compression knitwear and early activation (walking) after the procedure.

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