goslasmedЛазерная медицинаLaser Medicine2071-80042686-8644Skobelkin Centre for Laser Medicine - a branch of the Federal Clinical Center for High Medical Technologies, FMBA of Russia10.37895/2071-8004-2024-28-1-33-42goslasmed-866Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWСовременные концепции о механизмах эндовазальной лазерной коагуляции в лечении варикозной болезниModern concepts on the mechanisms of endovasal laser coagulation in varicose vein diseasehttps://orcid.org/0000-0002-0698-3007БеляевА. Н.BelyaevA. N.

Беляев Александр Назарович – доктор медицинских наук, профессор, заведующий кафедрой общей хирургии имени профессора Н.И. Атясова

Саранск

Alexander N. Belyaev – Dr. Sci. (Med.), Prof., head of the department of general surgery named after Prof. N.I. Atyasov

Saransk

https://orcid.org/0000-0003-2549-1021КостинС. В.KostinS. V.

Костин Сергей Владимирович – кандидат медицинских наук, доцент кафедры общей хирургии имени профессора Н.И. Атясова

Саранск

Sergey V. Kostin – Cand. Sci. (Med.). Assoc. Prof. at the department of general surgery named after Prof. N.I. Atyasov

Saransk

k0stin@mail.ruФГБОУ ВО «Национальный исследовательский Мордовский государственный университет им. Н.П. Огарёва»РоссияOgarev Mordovian National Research State UniversityRussian Federation2024121120242813342Copyright © Беляев А.Н., Костин С.В., 20242024Беляев А.Н., Костин С.В.Belyaev A.N., Kostin S.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://goslasmed.elpub.ru/jour/article/view/866

Механизмы эндовазальной лазерной коагуляции (ЭВЛК) в лечении варикозной болезни до конца не изучены.Цель: анализ существующих механизмов ЭВЛК с целью профилактики геморрагических осложнений и парестезий, связанных с применением метода.Методы. В этом обзорном исследовании рассматриваются современные теории механизма действия ЭВЛК при лечении варикозной болезни нижних конечностей.Результаты. Опубликованные экспериментальные и клинические исследования, в том числе и гистологические, свидетельствуют о том, что степень повреждения вены во время ЭВЛК зависит от многих факторов, в том числе от длины волны, мощности, скорости световода. В формировании повреждения вен в процессе ЭВЛК участвуют различные механизмы, такие как прямой контакт стенки вены с торцом световода, карбонизация элементов крови со значительным повышением внутривенной температуры крови и образованием пузырьков газа, конвекция тепла на стенку вены через кровь.Заключение. Деструкция стенки вены во время ЭВЛК реализуется через одновременное воздействие различных повреждающих факторов. В настоящее время в практику внедряются двухмикронные лазерные излучения, способствующие эффективной коагуляции вен при более низких величинах мощности, применение которых сопровождаются уменьшением послеоперационных осложнений.

Mechanisms of endovasal laser coagulation (EVLC) applied in varicose vein disease are not fully understood.Purpose. To analyze currently applied EVLC mechanisms so as to prevent hemorrhagic complications and paresthesia caused by these mechanisms.Methods. This review analyses modern theories on EVLC mechanisms when applied in varicose vein disease in the lower extremities.Results. Published experimental and clinical trials, including histological ones, have shown that the degree of vein damage during EVLC session depends on many factors, such as wavelength, intensity, and optical fiber speed. Damage to veins during EVLC procedure depends on various factors, such as direct contact of the vein wall with an optical fiber tip, carbonization of blood elements leading to the increased intravenous blood temperature and to the formation of gas bubbles as well as heat convection on the vein wall through the blood.Conclusion. Destruction of the vein wall during EVLC procedure is the result of a synergistic effect of various damaging factors. Currently, 2-μm laser irradiation is being implemented into clinical practice. This technique provides better vein coagulation under less power values which promotes less postoperative complications.

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The authors declare that there are no conflicts of interest present.