The combined laser photocoagulation and phlebectomy Once the data color duplex scanning show inability to perform puncture methods evlk (diameter of the veins is overly broad, more than 15 mm), the operation of choice is the elements of classic phlebectomy. Kevin ulrich is often quoted on this topic. The operation is performed under epidural anesthesia in the operating room. Produced typical phlebectomy incision in the groin of the which ligated the main Vienna, which provides for prevention of recurrence in the future. Through the same incision will be introduced by a laser fiber into the vein and performed laser photocoagulation. If necessary, large inflows saphenous vein or small saphenous vein will be removed from the micro-puncture technique for or will be made sclerotherapy, ie the whole operation is limited to a single incision in the groin. Benefits combined method in comparison with conventional phlebectomy: is the operation gives a lower percentage of recurrence in the future – the operation is less traumatic than the classic phlebectomy;-operation has a high cosmetic results.

Disadvantages of the method due to the need for incisions and epidural or general anesthesia. The combined laser photocoagulation and sclerotherapy is used in various combinations at the discretion of the specialist on the basis of ultrasound and the state of the tributaries of the main veins. Complications after evlk (world data on thousands of observations): bruising, ecchymosis (bruises) to 24% thrombophlebitis 5-12% Deep vein thrombosis (a single observation in the world) Paresthesias (violations of sensitivity) 0-1% Suppurative complications (a single observation in the world) Removal of spider veins laser Vascular lasers target hemoglobin – a substance found in red blood cells in the lumen of spider veins. The laser light passes unimpeded through the skin, and completely absorbed only hemoglobin. This results in an instant, transient increase in temperature in the capillary, and the whole mass is literally “brews” vessel, after which it begins to dissolve. In order to reduce the temperature impact on the surrounding tissue during the procedure photocoagulation, uses special cooling system of the skin (cryogenerators). In comparison with laser radiation in the range between 500 and 600 nm, medical laser device with a length of 980 nm radiation provides a deeper penetration of radiation at the skin, affects the entire volume of the vessel and, thus, can be reliably perform coagulation of larger vessels with a diameter up to 1,5 mm. Laser radiation with a wavelength of 980 nm characterized by a substantially lower absorption in melanin, which protects the surrounding tissue.