Laser technologies in the diagnostics and care of patients with decompensated forms of chronic venous insufficiency in the lower extremities

Abstract

Purpose. To assess the degree of disorders in regional microcirculation in patients with decompensated forms of chronic venous insufficiency of lower extremities and potentials for their correction with low-level laser therapy (LLLT).Material and methods. The authors analyzed results of examination and treatment of 66 patients with decompensated forms of chronic venous insufficiency in their lower extremities. 34 (51.5 %) patients, in addition to traditional therapy, had laser stimulation of microcirculation. For laser irradiation, infrared laser device “Mustang” (wavelength – 0.89 μm, frequency – 80 Hz, power – 10 W, exposure – 2 min per zone) was used. In laser course, there were 10 sessions. The state of microcirculation in tissues was examined with a computerized capillaroscope, a laser analyzer of capillary blood flow and a gas analyzer.Results. Microcirculation in patients with chronic venous insufficiency C6 has its specific features which, by findings of computerized capillaroscope, are manifested with deep suppression of tissue blood flow: namely, expressed polymorphism of capillary structures, violation of sizeratio of capillary sections, increased venous section, decreased density of the capillary network by 1.8 times, increased pericapillary zone by 1.47 times , decreased speed of capillary blood flow in the arterial section by 10.5 times and in the venous section by 11.5 times.Conclusion. Patients with decompensated forms of chronic venous insufficiency in lower extremities were observed to have significant morphological and functional changes in microcirculation, including structural changes in microvessels, decreased density of capillary network, increased prevascular zone, decreased speed of capillary blood flow. As a result, these changes cause disorders in tissue trophism, progressive decrease in TcpO2 and development of trophic ulcers. Low-level laser stimulation of microcirculation in the complex treatment of patients with decompensated forms of chronic venous insufficiency activates transcapillary metabolism, helps to restore structures and functions of microvasculature by increasing the myogenic activity of smooth muscle cells of arterioles and precapillaries as well as by normalizing arterio-venous relationships what accelerates tissue granulation and ulcer epithelialization.