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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
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Varicose veins are dilated branches of the great saphenous vein and small saphenous vein; the incidence of varicose veins varies from 10% to 30%.China Supply Custom Ammonium Bicarbonate In Biscuits 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.Wholesale Cheap OEM/ODM Fence Barb Wire Arm Suppliers & Manufacturers Quotes - Bluekin Industries Limited–Supply OEM Custom Mutivitamin Syrup Factory & Supplier Price - KeMing MedicinesHigh ligation and stripping is the traditional approach for varicose veins, yet a variety of alternative options have been used in recent decades,Supply OEM Custom Plastic Tote Dolly Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd.(EVLA),Wholesale CE High Quality Caesarean Section Dressing Factory & Supplier Price - Xingzhichen(RFA), foam sclerotherapy (FS),Wholesale Cheap OEM/ODM Stacking Plastic Crates Factory & Supplier Price - Zhongyi Plastic Technology Co.,Ltd..Wholesale CE High Quality Ring Shank Nail Products Cheap Price - Bluekin Industries Limited–Wholesale CE High Quality Plastic Foldable Crates For Collection Products Cheap Price - Zhongyi Plastic Technology Co.
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 Professional Nail Dryer Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRYThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.Wholesale CE High Quality 8 Cp95 /Nf13 - Sodium Cyclamate Factories & Manufacturers Pricelist - Huge Roc. 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 (Supply OEM Custom Sand Blasting Nozzle Factories & Manufacturers Pricelist - Mingou).Wholesale Cheap OEM/ODM Tennis Court Synthetic Turf Products Cheap Price - Green Link New Materials Co.Supply OEM Custom Mineral Wool Panel Factories & Manufacturers Pricelist - FOD Electrical Engineering.Supply OEM Custom Brown Rice Based Protein Powder Products Cheap Price - Huge Roc,Wholesale CE High Quality Floding Beach Barrel Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.China Supply Custom Mirror Polished Aluminum Coil Suppliers & Manufacturers Quotes - Shuanglin Jiate Metal Technology; 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 Soft Iron Wire Factories & Manufacturers Pricelist - Bluekin Industries Limited.
Indication and Contraindication of Treatment for Varicose Veins
The purpose of treatment is to relieve symptoms and prevent the progression of varicose veins.Wholesale Cheap OEM/ODM Temperature Control Wax Pot Heater Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY,China Supply Custom Library Mobile Shelving Products Cheap Price - INNOVATIVESymptomatic patients with C2 to C6 diseases are indicated for management,China Supply Custom Solid Plastic Crates Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd., superficial thrombophlebitis, and bleeding.
Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.China Supply Custom Modular Metal Shelving Suppliers & Manufacturers Quotes - INNOVATIVEHowever, 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 Electric Steamer Products Cheap Price - LONGBON INTERNATIONAL INDUSTRYbecause 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 Automatic Painting Machine Suppliers & Manufacturers Quotes - FOD Electrical Engineering, and early surgery in uncomplicated veins will not prevent the development of future varicosities.
Supply OEM Custom Good Quality Powder Coating Line Products Cheap Price - FOD Electrical Engineering, such as acute DVT,Wholesale Cheap OEM/ODM adhesive wound dressing Factories & Manufacturers Pricelist - Xingzhichenpregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,Wholesale Cheap OEM/ODM Tasteless Protein Powder Products Cheap Price - Huge Roc,China Supply Custom Buy Ammonium Carbonate Suppliers & Manufacturers Quotes - Huge Roc,China Supply Custom Perfect Whey Protein Factory & Supplier Price - Huge Roc—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.Supply OEM Custom Stainless Steel Nozzle Factory & Supplier Price - MingouThe 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 Electric Motor Housing Suppliers & Manufacturers Quotes - Highpoint MachineryIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (Wholesale Cheap OEM/ODM Saccharin Sodium 20-40 Mesh Suppliers & Manufacturers Quotes - Huge Roc). And massive bleeding due to injury to femoral veins,Supply OEM Custom 20awg Nickel Plated Copper Silicone Rubber Coated Wire Ul3141 Products Cheap Price - FOD Electrical Engineering, and mortality from pulmonary embolism and DVT can happen, even though these are rarely reported.
Table 2
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Supply OEM Custom Motto Barbed Wire Factory & Supplier Price - Bluekin Industries Limited; these belong to the category of minimally invasive catheter-based procedures.Supply OEM Custom G1/4 F Snow Foam Lance Factories & Manufacturers Pricelist - MingouIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.Wholesale Cheap OEM/ODM Games Manufacturer Products Cheap Price - Unionrise I&E. Alternatively,Supply OEM Custom Storage Mezzanines Factory & Supplier Price - INNOVATIVE.Supply OEM Custom Excavator Rock Bucket Factory & Supplier Price - Fenghe.Ltd.
Wholesale Cheap OEM/ODM Custom Wood Shelving Factories & Manufacturers Pricelist - INNOVATIVE, 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 Automatic Painting Machine Suppliers & Manufacturers Quotes - FOD Electrical Engineering,Wholesale Cheap OEM/ODM Organic Pea Powder Factory & Supplier Price - Huge Roc,10 Micron Stainless Steel Filter MeshWholesale Cheap OEM/ODM Razor Wire For Sale Suppliers & Manufacturers Quotes - Bluekin Industries Limited, recurrence rates,Wholesale CE High Quality Brown Rice Protein Benefits Factory & Supplier Price - Huge Roc.Wholesale CE High Quality Oil Colour Painting Set Factory & Supplier Price - Unionrise I&E,China Supply Custom Max Protein Factories & Manufacturers Pricelist - Huge Roc
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,Supply OEM Custom Diy Roller Foam Paint Brush Factory & Supplier Price - Unionrise I&ESupply OEM Custom Good Quality Powder Coating Line Products Cheap Price - FOD Electrical Engineering;Supply OEM Custom Sand Blasting Nozzle Factories & Manufacturers Pricelist - Mingou. Using proper compression stocking rather than bandage may reduce the risk of skin contusion. In addition, early ambulation is always critical to preventing DVT.China Supply Custom Metal Food Display Rack Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Beautiful Ladies Watch
Radiofrequency ablation
China Supply Custom White Chicken Wire Mesh Products Cheap Price - Bluekin Industries Limited; 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 18w 36w Uv Led Nail Dryer Lamp Factory & Supplier Price - LONGBON INTERNATIONAL INDUSTRY.
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 Decorative Chain Link Fence Factories & Manufacturers Pricelist - Bluekin Industries Limited,China Supply Custom Plain Aluminum Coil Products Cheap Price - Shuanglin Jiate Metal Technology,Wholesale CE High Quality Cell Phone Accessories Suppliers & Manufacturers Quotes - Shenzhen Hxs Technology
Foam sclerotherapy
Wholesale CE High Quality Blue Tempered And Waxed Steel Strap Factory & Supplier Price - Bluekin Industries Limited; it can be undertaken in the outpatient clinic,Wholesale Cheap OEM/ODM Coating Aluminum Foil Suppliers & Manufacturers Quotes - Shuanglin Jiate Metal Technology.Wholesale Cheap OEM/ODM Plastic Floor Camping Mats Suppliers & Manufacturers Quotes - Green Link New Materials Co.Observational studies found that success rates vary from 82% to 100%,Snatch Block With HookSupply OEM Custom Disposable Antibacterial Face Mask Products Cheap Price - Xingzhichen. 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 (China Supply Custom Back Pain Plaster Suppliers & Manufacturers Quotes - Xingzhichen). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Ltd.
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 Solid Plastic Crates Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ar Abrasion-resistant Clear 3mm Lexan Board
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Supply OEM Custom Brown Rice Based Protein Powder Products Cheap Price - Huge Roc. The most common cause is the valve insufficiency of the deep veins due to DVT; in rare conditions it can be due to congenital valve or vessel abnormalities.Wholesale CE High Quality Plain Protein Powder Factory & Supplier Price - Huge Roc,China Supply Custom Alloy Steel Parts Factory & Supplier Price - Fenghe.Wholesale Cheap OEM/ODM First Aid Wound Dressing Factories & Manufacturers Pricelist - XingzhichenWholesale CE High Quality Pallet Warehouse Factories & Manufacturers Pricelist - INNOVATIVE.Supply OEM Custom Replacer Organic Rice Protein Products Cheap Price - Huge Roc.China Supply Custom Artificial Palm Tree Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd..Wholesale Cheap OEM/ODM Mini Bear Finger & Toe Nail Dryer Factory & Supplier Price - LONGBON INTERNATIONAL INDUSTRY.Wholesale CE High Quality Universal Whey Protein Factories & Manufacturers Pricelist - Huge Roc. External valvuloplasty, such as external vein valve wrapping,China Supply Custom Diy Craft Products Cheap Price - Unionrise I&E.China Supply Custom Gold Aluminum Foil Factories & Manufacturers Pricelist - Shuanglin Jiate Metal TechnologyIt aims to increase the coating surface and restore valve competency by external supportSupply OEM Custom 3m Rubber Floor Mat Suppliers & Manufacturers Quotes - Green Link New Materials Co.and has not gained large popularity due to its efficacy. However,China Supply Custom Mobile Shelving Units Suppliers & Manufacturers Quotes - INNOVATIVE.Wholesale Cheap OEM/ODM Timber Shelves Factories & Manufacturers Pricelist - INNOVATIVE
Overall, all management modalities appear to be safe and effective in the short term and midterm,Stainless Steel PadlockSupply OEM Custom Handwarmer Factory & Supplier Price - Jade Rabbit Electrical Appliance.Wholesale CE High Quality Artificial Leaf Stem Factory & Supplier Price - Green Link New Materials Co., Ltd.;China Supply Custom Butane Hand Warmer Suppliers & Manufacturers Quotes - Jade Rabbit Electrical Appliance. FS was associated with the highest failure rate.Supply OEM Custom Food Grade Use Of Ammonium Bicarbonate Suppliers & Manufacturers Quotes - Huge Roc,China Supply Custom 50ml 100ml Vitamin B Complex Injection Factory & Supplier Price - KeMing MedicinesHowever, high-Supply OEM Custom Tape For Wound Dressing Factory & Supplier Price - Xingzhichen-term follow-China Supply Custom Calcium Propionate 99% Food Grade Factories & Manufacturers Pricelist - 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
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