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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
Supply OEM Custom Animal Medicine Suppliers & Manufacturers Quotes - KeMing Medicines. There are a variety of management modalities for varicose veins. The outcomes of the treatment of varicose veins are different. The papers on China Supply Custom Wire Mesh Used Suppliers & Manufacturers Quotes - Bluekin Industries Limited.China Supply Custom Q235 High Tensile Blue Steel Strapping Products Cheap Price - Bluekin Industries Limited.Wholesale Cheap OEM/ODM Ulcer Wound Dressing Factory & Supplier Price - Xingzhichen.Supply OEM Custom Soy Lecithin Powder Suppliers & Manufacturers Quotes - Huge Roc.
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 Cheap OEM/ODM Sodium Saccharin Uses Factory & Supplier Price - Huge RocRisk factors of varicose veins include family history, age, and pregnancy; a possible risk factor is standing for a long period of time.Supply OEM Custom Zippo Hand Warmer Suppliers & Manufacturers Quotes - Jade Rabbit Electrical Appliance–Ltd.High 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 Temperature Control Wax Pot Heater Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY(EVLA),Supply OEM Custom 8 - Pea Protein Isolate Factories & Manufacturers Pricelist - Huge Roc(RFA), foam sclerotherapy (FS),Supply OEM Custom High Pressure Water Hose Factories & Manufacturers Pricelist - Mingou.Wholesale CE High Quality Adhesive Transparent Dressing Products Cheap Price - Xingzhichen–m.ds-gasspring.com
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).China Supply Custom Feed Grade Rice Protein Products Cheap Price - Huge RocThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.China Supply Custom 1/4 Pressure Washer Drain Sewer Cleaning Nozzle Suppliers & Manufacturers Quotes - Mingou. 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 (China Supply Custom Pvc Mesh Products Cheap Price - Bluekin Industries Limited).China Supply Custom Rheumatism Adhesive Pain Relief Plaster Factories & Manufacturers Pricelist - XingzhichenWholesale Cheap OEM/ODM Wooden Bathroom Shelves Suppliers & Manufacturers Quotes - INNOVATIVE.Ltd.,gjmach-chnWholesale Cheap OEM/ODM Garage Shelving Systems Factory & Supplier Price - INNOVATIVE; 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,Wholesale Cheap OEM/ODM Silver Welding Rod Factories & Manufacturers Pricelist - Bluekin Industries Limited.
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.China Supply Custom Carbon Steel Parts Products Cheap Price - Fenghe,Supply OEM Custom Vitamin B Complex Capsules Products Cheap Price - KeMing MedicinesSymptomatic patients with C2 to C6 diseases are indicated for management,Wholesale Cheap OEM/ODM Elite Protein Powder Factories & Manufacturers Pricelist - Huge Roc, superficial thrombophlebitis, and bleeding.
Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.China Supply Custom Rice Protein Isolated Suppliers & Manufacturers Quotes - Huge RocHowever, 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 18 Awg Wire Suppliers & Manufacturers Quotes - Bluekin Industries Limitedbecause 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 Turf Artificial Grass Football Suppliers & Manufacturers Quotes - Green Link New Materials Co., Ltd., and early surgery in uncomplicated veins will not prevent the development of future varicosities.
Supply OEM Custom Galvanized Nails For Nail Gun Factory & Supplier Price - Bluekin Industries Limited, such as acute DVT,Wholesale Cheap OEM/ODM Children Foam Toys Products Cheap Price - Unionrise I&Epregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,China Supply Custom Electronic Hair Straightener Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY,China Supply Custom Hard Drawn Wire Factories & Manufacturers Pricelist - Bluekin Industries Limited,Wholesale Cheap OEM/ODM Large Artificial Trees Factory & Supplier Price - 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 Alginate Fiber Wound Dressings Products Cheap Price - XingzhichenThe 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.China Supply Custom V Protein Powder Suppliers & Manufacturers Quotes - Huge RocIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (China Supply Custom Mirror Polished Aluminum Coil Suppliers & Manufacturers Quotes - Shuanglin Jiate Metal Technology). And massive bleeding due to injury to femoral veins,China Supply Custom Plastic Net Baskets Factory & Supplier Price - Zhongyi Plastic Technology Co.,Ltd., 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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Wholesale Cheap OEM/ODM Natural Material Facial Mask Factories & Manufacturers Pricelist - Xingzhichen; these belong to the category of minimally invasive catheter-based procedures.Wholesale Cheap OEM/ODM Lecithin Supplement Products Cheap Price - Huge RocIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.China Supply Custom Electrostatic Powder Coating Spray Gun Products Cheap Price - FOD Electrical Engineering. Alternatively,Supply OEM Custom Plastic Compartment Storage Box Factory & Supplier Price - Zhongyi Plastic Technology Co.,Ltd..China Supply Custom Antibiotic Powder Factory & Supplier Price - KeMing Medicines.Supply OEM Custom Storage Pallets For Sale Products Cheap Price - INNOVATIVE
Supply OEM Custom Calcium Propionate Price Products Cheap Price - Huge Roc, 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. Ltd.,Wholesale CE High Quality Ivermectin Injection 1% Veterinary Medicine Products Cheap Price - KeMing Medicines,Wholesale CE High Quality Vitamin Ampoules Injection Factories & Manufacturers Pricelist - KeMing MedicinesWholesale CE High Quality Rotor Assembly Machine Suppliers & Manufacturers Quotes - Ningbo Nide Mechanical Equipment Co., Ltd., recurrence rates,Wholesale CE High Quality Cell Phone Case Suppliers & Manufacturers Quotes - Shenzhen Hxs Technology.China Supply Custom Non-Galvanized Welded Wire Mesh Factory & Supplier Price - Bluekin Industries Limited,Supply OEM Custom Standard Custom Five Axis Reciprocating Machine With Four Plates Factory & Supplier Price - FOD Electrical Engineering
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,China Supply Custom Reinforced Mesh Factories & Manufacturers Pricelist - Bluekin Industries LimitedWholesale CE High Quality Hair Curler Suppliers Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY;Wholesale CE High Quality 22 Awg Wire Factory & Supplier Price - Bluekin Industries Limited. 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 Hand Warmers Football Factory & Supplier Price - Jade Rabbit Electrical Appliance,Water Purifier Circuit Board
Radiofrequency ablation
Wholesale CE High Quality 10% Butafosfan Vitamin B12 Injection Suppliers & Manufacturers Quotes - KeMing Medicines; 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 Nutribiotic Rice Protein Suppliers & Manufacturers Quotes - Huge Roc.
Currently available clinical trial evidence suggests RFA and EVLA are at least as effective as surgery in the treatment of great saphenous varicose veins.Wholesale CE High Quality PU dressing Suppliers & Manufacturers Quotes - Xingzhichen,Wholesale CE High Quality Pallet Warehouse Factories & Manufacturers Pricelist - INNOVATIVE,Wholesale CE High Quality Inside Spraying Painting Machine Forglass Bottles Suppliers & Manufacturers Quotes - FOD Electrical Engineering
Foam sclerotherapy
Wholesale Cheap OEM/ODM Hot Sale Soy Lecithin Factories & Manufacturers Pricelist - Huge Roc; it can be undertaken in the outpatient clinic,Wholesale CE High Quality Plastic Crate With Foldable Lids Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.,Ltd..Wholesale CE High Quality Artificial Turf Golf Factory & Supplier Price - Green Link New Materials Co.Observational studies found that success rates vary from 82% to 100%,Perfluorinated Alcohol Polyoxyethylene EtherWholesale Cheap OEM/ODM Kid Drawing Board Suppliers & Manufacturers Quotes - Unionrise I&E. 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 CE High Quality Artificial Leaf Craft Factories & Manufacturers Pricelist - Green Link New Materials Co.). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Wholesale Cheap OEM/ODM Hot Sale Soy Lecithin Factories & Manufacturers Pricelist - 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.Wholesale CE High Quality Artificial Roses Leaf Factories & Manufacturers Pricelist - Green Link New Materials Co.,ceramic crucible
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Overall, all management modalities appear to be safe and effective in the short term and midterm,Supply OEM Custom Multi Vitamin Factory & Supplier Price - KeMing MedicinesWholesale Cheap OEM/ODM Field Fence Suppliers & Manufacturers Quotes - Bluekin Industries Limited.Supply OEM Custom Vitamin B Complex Factory & Supplier Price - KeMing Medicines;Supply OEM Custom Hotsell Soccer Artificial Turf Products Cheap Price - Green Link New Materials Co., Ltd.. FS was associated with the highest failure rate.Wholesale CE High Quality Protein Powder Online Factory & Supplier Price - Huge Roc,Wholesale Cheap OEM/ODM Warehouse Pallet Racking Systems Suppliers & Manufacturers Quotes - INNOVATIVEHowever, high-Wholesale Cheap OEM/ODM Vitamin C Tablet Rose Hip Factories & Manufacturers Pricelist - KeMing Medicines-term follow-China Supply Custom Electrical Wire Flat Cable Products Cheap Price - FOD Electrical Engineering.
Acknowledgments
The first three authors (FL, YS, SZ) contributed equally to this article.
References
Articles fromInternational Surgeryare provided here courtesy ofInternational College of Surgeons
