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Fan Lin
1Department of Vascular Surgery, China-Japan Friendship Hospital No. 2, Yinghua yuan East Road, Beijing, China
Shiyi Zhang
2Department of Vascular Surgery, Shandong Provincial Hospital, Shandong University, Jinan Shandong, China
Yan Sun
2Department of Vascular Surgery, Shandong Provincial Hospital, Shandong University, Jinan Shandong, China
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1Department of Vascular Surgery, China-Japan Friendship Hospital No. 2, Yinghua yuan East Road, Beijing, China
Peng Liu
1Department of Vascular Surgery, China-Japan Friendship Hospital No. 2, Yinghua yuan East Road, Beijing, China
Abstract
Wholesale Cheap OEM/ODM Nestable Plastic Packaging Crate Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd.. There are a variety of management modalities for varicose veins. The outcomes of the treatment of varicose veins are different. The papers on Wholesale CE High Quality Armature Testing Panel Factories & Manufacturers Pricelist - Ningbo Nide Mechanical Equipment Co., Ltd..Wholesale Cheap OEM/ODM Green Peas Protein Suppliers & Manufacturers Quotes - Huge Roc.Supply OEM Custom Fep/Pfa Cable Factory & Supplier Price - FOD Electrical Engineering.Supply OEM Custom Spiral Bevel Gear Suppliers & Manufacturers Quotes - Fenghe.
Varicose veins are dilated branches of the great saphenous vein and small saphenous vein; the incidence of varicose veins varies from 10% to 30%.Wholesale CE High Quality Outdoor Artificial Turf Products Cheap Price - Green Link New Materials Co.Risk factors of varicose veins include family history, age, and pregnancy; a possible risk factor is standing for a long period of time.Wholesale CE High Quality Farm Tractor Suppliers & Manufacturers Quotes - Fenghe–Wholesale Cheap OEM/ODM Nail Polish Suppliers China Factory & Supplier Price - Bluekin Industries LimitedHigh ligation and stripping is the traditional approach for varicose veins, yet a variety of alternative options have been used in recent decades,Wholesale Cheap OEM/ODM Children Foam Toys Products Cheap Price - Unionrise I&E(EVLA),Wholesale Cheap OEM/ODM Painted Aluminum Coil Products Cheap Price - Shuanglin Jiate Metal Technology(RFA), foam sclerotherapy (FS),Wholesale CE High Quality Solid Timber Floating Shelves Factory & Supplier Price - INNOVATIVE.China Supply Custom Mini Nail Dryer Lamp Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY–Wholesale Cheap OEM/ODM Machine To Manufacture Screw Nails Products Cheap Price - Bluekin Industries Limited
Manifestation and Severity of Varicose Veins
Patients with varicose veins present from asymptomatic to significant symptoms, including discomfort, aching, pain, itching or eczema, and deep vein thrombosis (DVT).Wholesale CE High Quality Embossed Aluminum Sheet Products Cheap Price - Shuanglin Jiate Metal TechnologyThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.Supply OEM Custom Mirror Polished Aluminum Coil Factories & Manufacturers Pricelist - Shuanglin Jiate Metal Technology. The CEAP (clinical, etiology, anatomy, pathophysiology) classification is used to describe the degree of varicose veins. The “C” part of CEAP classification is more useful and practical in rating the severity of varicose veins (Wholesale Cheap OEM/ODM Pea Protein Wholesale Products Cheap Price - Huge Roc).China Supply Custom Lotion Emulsifying Machine Factories & Manufacturers Pricelist - Huge RocWholesale Cheap OEM/ODM Warehouse Pallet Racking Systems Suppliers & Manufacturers Quotes - INNOVATIVE.Wholesale CE High Quality Glue &Glitter Glue Factories & Manufacturers Pricelist - Unionrise I&E,Wholesale CE High Quality Military Barbed Wire Factories & Manufacturers Pricelist - Bluekin Industries LimitedChina Supply Custom 9w Uv Nail Lamp Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY; it can provide a road map of vein anatomy similar to contrast venography, as well as essential hemodynamic information about the presence of proximal obstruction, vein valve function,China Supply Custom Antibiotics Lincomycin Hcl Capsule Factories & Manufacturers Pricelist - KeMing Medicines.
Table 1
CEAP classification: C (clinical component)
Indication and Contraindication of Treatment for Varicose Veins
The purpose of treatment is to relieve symptoms and prevent the progression of varicose veins.Wholesale CE High Quality Sun9s Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRY,Wholesale CE High Quality Oem Hair Straightener Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRYSymptomatic patients with C2 to C6 diseases are indicated for management,China Supply Custom Natural Rice Protein Isolate Powder Factory & Supplier Price - Huge Roc, superficial thrombophlebitis, and bleeding.
Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.Wholesale Cheap OEM/ODM Atv Hand Warmers Factories & Manufacturers Pricelist - Jade Rabbit Electrical ApplianceHowever, cosmesis is a common reason for treatment of asymptomatic patients, especially for young female patients. It is controversial to perform surgery on patients who have recovered from the superficial phlebitis,Wholesale Cheap OEM/ODM Pea And Rice Protein Suppliers & Manufacturers Quotes - Huge Rocbecause the dilated varicose veins usually disappeared without further surgical treatment. It is not indicated to perform thrombectomy for superficial thrombosis in great saphenous veins.China Supply Custom Aluminium Casting CNC Suppliers & Manufacturers Quotes - Highpoint Machinery, and early surgery in uncomplicated veins will not prevent the development of future varicosities.
Supply OEM Custom Bicarbonate Sodium/Sodium Bicarbonate Food Grade Factories & Manufacturers Pricelist - Huge Roc, such as acute DVT,Wholesale CE High Quality Vitamin E Capsules Products Cheap Price - KeMing Medicinespregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,Supply OEM Custom Commutator Fusing Machine Suppliers & Manufacturers Quotes - Ningbo Nide Mechanical Equipment Co., Ltd.,Supply OEM Custom Organic Brown Rice Protein Products Cheap Price - Huge Roc,Wholesale Cheap OEM/ODM Artificial Synthetic Turf Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd.—further imaging to assess the patency of the deep veins is critical before surgery. Emergent management is usually reserved for bleeding varicosities or suspected DVT.
Modalities for Management of Varicose Veins
Conventional surgical stripping
All management modalities for varicose veins are safe and effective at short-term and midterm follow-up.China Supply Custom Mobile Phone Case Suppliers Factories & Manufacturers Pricelist - Shenzhen Hxs TechnologyThe methods to manage great saphenous veins traditionally include ligation and division of the saphenofemoral junction and its tributaries in the groin, stripping the great saphenous veins from groin to knee level. The incompetent small saphenous veins are ligated and divided, rather than stripped, close to the popliteal vein in the knee pit, because stripping small saphenous veins may potentially damage the sural nerve.Wholesale CE High Quality Hot Sale Isolated Soy Protein Suppliers & Manufacturers Quotes - Huge RocIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (Wholesale CE High Quality Lead Head Nail Suppliers & Manufacturers Quotes - Bluekin Industries Limited). And massive bleeding due to injury to femoral veins,Supply OEM Custom White Wooden Shelf Brackets Factory & Supplier Price - INNOVATIVE, and mortality from pulmonary embolism and DVT can happen, even though these are rarely reported.
Table 2
Complications after different modalities for varicose veins
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China Supply Custom Wax Warmer Kit Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY; these belong to the category of minimally invasive catheter-based procedures.Wholesale CE High Quality Slimming Dietary Fiber Suppliers & Manufacturers Quotes - Huge RocIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.Supply OEM Custom Mini Football Field Artificial Turf Suppliers & Manufacturers Quotes - Green Link New Materials Co., Ltd.. Alternatively,Wholesale Cheap OEM/ODM Spraying Paint Reciprocating Equipment Products Cheap Price - FOD Electrical Engineering.Wholesale Cheap OEM/ODM Wooden Kitchen Shelves Suppliers & Manufacturers Quotes - INNOVATIVE.Supply OEM Custom Mezzanine Level Suppliers & Manufacturers Quotes - INNOVATIVE
China Supply Custom Plastic Crates Hinged Products Cheap Price - Zhongyi Plastic Technology Co.,Ltd., no need for hospital admission, no surgical incision, and early resumption of daily activity or work are advantages of this procedure. However, like other surgeries, EVLA still can cause operative or postoperative complications, such as hematoma, infection, skin burn, bruising, and catheter stabbing by laser fiber, or the broken catheter can be left in the body.China Supply Custom Raw Brown Rice Protein Suppliers & Manufacturers Quotes - Huge Roc,Wholesale Cheap OEM/ODM Best Sources Of Dietary Fiber Products Cheap Price - Huge Roc,Tungsten Carbide InsertsWholesale CE High Quality Rope Course Advanture Factory & Supplier Price - Shanghai Mutong Toys, recurrence rates,Wholesale CE High Quality Hard Drawn Wire Factories & Manufacturers Pricelist - Bluekin Industries Limited.Wholesale Cheap OEM/ODM Duckback Hot Water Bag Factory & Supplier Price - Jade Rabbit Electrical Appliance,Wholesale Cheap OEM/ODM Crochet Hand Warmers Products Cheap Price - Jade Rabbit Electrical Appliance
Clinical experience shows that the pain after laser ablation contributes to the skin contusion caused between skin and uneven bandages used after the procedure, blisters induced by skin burn,Wholesale CE High Quality Blue And Waxed Steel Strapping Products Cheap Price - Bluekin Industries LimitedWholesale Cheap OEM/ODM Expendable Thermocouple Factory & Supplier Price - FOD Electrical Engineering;China Supply Custom Unflavored Whey Protein Factories & Manufacturers Pricelist - Huge Roc. Using proper compression stocking rather than bandage may reduce the risk of skin contusion. In addition, early ambulation is always critical to preventing DVT.Wholesale Cheap OEM/ODM Bird Cage Welded Wire Mesh Roll Suppliers & Manufacturers Quotes - Bluekin Industries Limited,Black Sump Slurry Pumps Wholesaler Quotes & PriceList
Radiofrequency ablation
Supply OEM Custom Spray Painting Machine Suppliers & Manufacturers Quotes - FOD Electrical Engineering; it delivers thermal energy from a bipolar catheter to the insufficient veins. RFA is an effective and safe treatment modality for incompetent veins, and it can be performed in-office as a minimally invasive procedure. The advantages of RFA include low complication rate, reduced pain, high vein occlusion rates,Supply OEM Custom Delcom Electric Warm Bag Factories & Manufacturers Pricelist - Jade Rabbit Electrical Appliance.
Currently available clinical trial evidence suggests RFA and EVLA are at least as effective as surgery in the treatment of great saphenous varicose veins.China Supply Custom Painting & Colouring Sets Suppliers & Manufacturers Quotes - Unionrise I&E,Supply OEM Custom Wooden Shelving Systems Products Cheap Price - INNOVATIVE,China Supply Custom Electric Pressure Washer Factory & Supplier Price - Mingou
Foam sclerotherapy
Wholesale Cheap OEM/ODM Gun-Fix Automatic Uv Paint Spraying Line Suppliers & Manufacturers Quotes - FOD Electrical Engineering; it can be undertaken in the outpatient clinic,China Supply Custom Hangzhou Jinding Aluminium Industry Suppliers & Manufacturers Quotes - Shuanglin Jiate Metal Technology.Supply OEM Custom Nutribiotic Rice Protein Suppliers & Manufacturers Quotes - Huge RocObservational studies found that success rates vary from 82% to 100%,China Supply Custom Hot Water Bottle Cover Suppliers & Manufacturers Quotes - Jade Rabbit Electrical ApplianceWholesale CE High Quality High Protein Brown Rice Suppliers & Manufacturers Quotes - Huge Roc. It takes approximately 1 hour to perform FS, patients do not need to take medicine or stay in the hospital, and patients can go home or continue to work immediately after the procedure. The efficacy of FS is obvious in comparison with conventional surgical stripping (Wholesale Cheap OEM/ODM Best Sources Of Fiber In Food Products Cheap Price - Huge Roc). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Supply OEM Custom Soybeans Protein Products Cheap Price - Huge Roc
Comparison of postoperative outcomes after conventional surgical stripping (A) with FS (B and C). Multiple surgical scars seen after surgical stripping (A); no visible varicose veins seen 4 days after FS (C) versus obvious varicose veins prior to FS.
Ambulatory phlebectomy
Ambulatory phlebectomy is an outpatient procedure that removes superficial veins through small 2- to 3-mm incisions in the skin overlying the varicose veins and is performed under local anesthesia. The accepted indications for this technique are side branch varicose veins, and varicose veins of the foot, around the ankle, and the knee pit. The most important instrument for this technique is the vein retractor or phlebectomy hook. There are two ways by which the veins can be grasped. The phlebectomy hook is inserted through an incision and the varicose vein is hooked, extracted, and subsequently fixed with a clamp; the vein is finally pulled out by turning the exteriorized part of the vein. Graded compression stockings or compression bandages are usually used for 1 to 2 weeks after the procedure. This procedure is often used as an adjunct to EVLA or RFA, either concomitantly or in the sequential management of tributaries for symptomatic varicose veins. The complications are uncommon but include paresthesia, bruising, hemorrhage, and hematoma. EVLA with with both treatments achieves excellent results at 5 years. Concomitant treatment of varicosities is associated with optimal improvement in both clinical disease severity and quality of life.Supply OEM Custom Sodium Saccharin Food Grade Products Cheap Price - Huge Roc,Wholesale CE High Quality Antianemic Agents Products Cheap Price - KeMing Medicines
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Overall, all management modalities appear to be safe and effective in the short term and midterm,Wholesale Cheap OEM/ODM Soy Lecithin Emulsifiers Factory & Supplier Price - Huge RocChina Supply Custom Spray Paint Ventilation System Factories & Manufacturers Pricelist - FOD Electrical Engineering.China Supply Custom Armature Winder Factory & Supplier Price - Ningbo Nide Mechanical Equipment Co., Ltd.;Supply OEM Custom Overhead Rack Factory & Supplier Price - INNOVATIVE. FS was associated with the highest failure rate.Ltd., Ltd.However, high-Supply OEM Custom Injection Machine Plastic Crates Factory & Supplier Price - Zhongyi Plastic Technology Co.,Ltd.-term follow-Wholesale CE High Quality Pea Protein Food Grade Factory & Supplier Price - Huge Roc.
Acknowledgments
The first three authors (FL, YS, SZ) contributed equally to this article.
References
Articles fromInternational Surgeryare provided here courtesy ofInternational College of Surgeons
