EVLT and DVT with its comlications GUEST LECTURE 30 NOVEMBER 2024.pptx

EVLT and DVT with its comlications GUEST LECTURE 30 NOVEMBER 2024.pptx

1. EVLT and DVT with its complications? DR SATYENDRA KUMAR TIWARY, MS, MAMS, FICS, FIAGES, FMAS PROFESSOR, DEPARTMENT OF GENERAL SURGERY, INSTITUTE OF MEDICAL SCIENCES, BANARAS HINDU UNIVERSITY, VARANASI 221005.

2. EVLT/EVLA/LASER

3. A,B,C………Warm Up A: Assessment, Anatomy, Access, Activity, ABI, Ablation B: Biologics, Bi-layered Dressings C: Compression (CENTRAL) D: Duplex, Drugs, Diet, Dressings E: Endo-venous intervention, Endoscopic Ultrasound, Exercises F: Four layer Dressing ,Flavenoids (MPFF)

4. Pathophysiology

5. Outline Of EVLT Indications Technique Potential C omplications C linical S ignificance Interprofessional team strategies Health Promotion Health Protection

6. A chronic disease, and the procedure is by no means a cure.  P hysiologic and psychological benefits Minimally invasive Same day discharge( Day Care) Improved Quality of Life Prevention of Progression of Stage (C2 onwards)

7. Preparation for EVLT Medical Assessment: Thorough medical assessment Physical examination Ultrasound to map out the veins. Pre-Procedure Instructions: Avoid certain medications Fasting Local Anaesthesia : Comfortable for the patient.

8. Procedural Steps: Ultrasound Guidance Access Incision and Fiber Insertion Laser Activation Removal of Equipment Dressing

9. Post-Procedure Care Compression Stockings Activity Follow-Up Appointments

10. Potential Risks and Complications Common Side Effects(Minor): Mild bruising, Swelling, and Discomfort Less Common Complications(Major): DVT Nerve injury, or Skin burns.

11. Complications Thrombosis Hematoma and ecchymoses Skin burns Nerve damage Recurrence

12. Contraindications Acute deep vein thrombosis Arterial insufficiency Acute skin infection at the site of entry Obstruction of the deep vein where the target vein serves as collateral Pregnancy

13. Benefits of EVLT Effectiveness EVLT has a high success rate and is very effective in treating varicose veins. Minimally Invasive The procedure is less invasive compared to traditional vein stripping surgery. Quick Recovery Patients typically experience a quick recovery with minimal downtime.

14. OUR EXPERINCE (2009-2024) at IMS, BHU, VARANASI PROCEDURE No. of Cases(n=758) Minor Complications Major Complications Recurrence EVLT 236 26(11%) 4(1.6%) 7(3%) RFA 387 35(9%) 1(0.24%) 12(3.2%) Trendelenburg Operation 112 11(10%) 3(2.8%) 8(6.5%) Combined 23 2(9%)

15. Deep Vein Thrombosis Complications

16. Complications Pulmonary Embolism (PE): A blood clot from a DVT can break free and travel to the lungs, blocking blood flow. This is a potentially life-threatening condition Sudden shortness of breath, chest pain, rapid heart rate, and coughing up blood. Post-Thrombotic Syndrome (PTS): Damage to the veins from a blood clot can reduce blood flow, leading to long-term symptoms. Chronic leg pain, swelling, skin discoloration, and varicose veins Chronic Venous Insufficiency (CVI): Similar to PTS, CVI results from damaged veins that can't efficiently return blood to the heart. Persistent leg swelling, pain, and skin changes. Phlegmasia Cerulea Dolens : A rare but severe complication where a blood clot causes significant swelling and pain due to lack of blood flow (ischemia) to the leg. Severe leg swelling, pain, and blue discoloration of the skin. Paradoxical Embolism: A blood clot passes through a hole in the heart and travels to the brain, causing a stroke.

17. Prevention & Management Coagulation Prevention Medications: Blood thinners (anticoagulants) are commonly used to prevent clot formation and growth. Compression Stockings: Wearing these can help improve blood flow and reduce swelling. Changed Lifestyle: Staying active, avoiding prolonged immobility, and maintaining a healthy weight can help prevent DVT.