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Int Surg. 2015 Jan; 100(1): 185–189.
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Abstract

Wholesale CE High Quality Vegetable Protein Isolate Products Cheap Price - Huge Roc. 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 Motor Wire Winding Machines Factory & Supplier Price - Ningbo Nide Mechanical Equipment Co., Ltd..Wholesale Cheap OEM/ODM Hand Warmer Packs Factory & Supplier Price - Jade Rabbit Electrical Appliance.Supply OEM Custom Automotive Spray Booth Suppliers & Manufacturers Quotes - FOD Electrical Engineering.Wholesale CE High Quality Calcium Propionate Uses Factories & Manufacturers Pricelist - 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%.China Supply Custom Buy Rice Protein Products Cheap 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 Crate For Turnover Container Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.–Wholesale CE High Quality Fermented Brown Rice Protein Powder Factories & Manufacturers Pricelist - Huge RocHigh ligation and stripping is the traditional approach for varicose veins, yet a variety of alternative options have been used in recent decades,Wholesale CE High Quality Best Pea Protein Powder For Weight Loss Suppliers & Manufacturers Quotes - Huge Roc(EVLA),Supply OEM Custom Nested And Plastic Box Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd.(RFA), foam sclerotherapy (FS),China Supply Custom Vitamin B Complex Syrup Factory & Supplier Price - KeMing Medicines.China Supply Custom Hangzhou Jinding Aluminium Industry Suppliers & Manufacturers Quotes - Shuanglin Jiate Metal Technology–Wholesale Cheap OEM/ODM Dietary Fiber Examples Suppliers & Manufacturers Quotes - Huge Roc

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 18 Gauge Binding Wire Specifications Suppliers & Manufacturers Quotes - Bluekin Industries LimitedThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.Wholesale Cheap OEM/ODM Natural Soya Bean Lecithin Suppliers & Manufacturers Quotes - 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 (Wholesale Cheap OEM/ODM Stator Forming Machine Suppliers & Manufacturers Quotes - Ningbo Nide Mechanical Equipment Co.).Wholesale CE High Quality Logistic Plastic Crate With Lid Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.Wholesale Cheap OEM/ODM Vitamin Ad3e Injection Products Cheap Price - KeMing Medicines.Supply OEM Custom Disposable Face Mask Suppliers & Manufacturers Quotes - Xingzhichen,Wholesale Cheap OEM/ODM Artist Painting Brush Products Cheap Price - Unionrise I&EWholesale CE High Quality Fire Resistant Cable Suppliers & Manufacturers Quotes - FOD Electrical Engineering; 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 CE High Quality Oil Antimalarials Easy To Use Suppliers & Manufacturers Quotes - KeMing Medicines.

Table 1

CEAP classification: C (clinical component)

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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 Calcium Propionate Vegan Products Cheap Price - Huge Roc,Wholesale CE High Quality Fiber Diets For Adults Factory & Supplier Price - Huge RocSymptomatic patients with C2 to C6 diseases are indicated for management,Wholesale CE High Quality Pine Shelving Timber Factories & Manufacturers Pricelist - INNOVATIVE, superficial thrombophlebitis, and bleeding.

Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.Wholesale Cheap OEM/ODM High Pressure Hose Factories & Manufacturers Pricelist - MingouHowever, 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,Kids Indoor Playground Commercialbecause the dilated varicose veins usually disappeared without further surgical treatment. It is not indicated to perform thrombectomy for superficial thrombosis in great saphenous veins.Supply OEM Custom Painting Palette Factories & Manufacturers Pricelist - Unionrise I&E, and early surgery in uncomplicated veins will not prevent the development of future varicosities.

China Supply Custom Soya Bean Factory & Supplier Price - Huge Roc, such as acute DVT,China Supply Custom Organic Soy Lecithin Factory & Supplier Price - Huge Rocpregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,China Supply Custom Galvanized Wire Mesh 2 Mesh 5x5 Suppliers & Manufacturers Quotes - Bluekin Industries Limited,China Supply Custom Folding Shopping Crate Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.,Ltd.,Supply OEM Custom Warehouse Racking Costs Suppliers & Manufacturers Quotes - INNOVATIVE—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.Wholesale Cheap OEM/ODM 99% Artemisinin Products Cheap Price - KeMing MedicinesThe 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 Good Wax Warmer Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRYIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (Wholesale Cheap OEM/ODM Sodium Saccharin Uses Factory & Supplier Price - Huge Roc). And massive bleeding due to injury to femoral veins,China Supply Custom Floating Timber Shelving Factories & Manufacturers Pricelist - 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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Supply OEM Custom Zippo Hand Warmer Suppliers & Manufacturers Quotes - Jade Rabbit Electrical Appliance; these belong to the category of minimally invasive catheter-based procedures.Supply OEM Custom Zippo Hand Warmer Suppliers & Manufacturers Quotes - Jade Rabbit Electrical ApplianceIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.China Supply Custom Brown Rice Pea Protein Factory & Supplier Price - Huge Roc. Alternatively,Wholesale Cheap OEM/ODM Plastic High Pressure Water Hose Products Cheap Price - Mingou.Wholesale CE High Quality Sand Blasting Gun Products Cheap Price - Mingou.Ltd.

Supply OEM Custom Artificial Plants Trees Suppliers & Manufacturers Quotes - Green Link New Materials 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.Wholesale CE High Quality Adhesive Transparent Dressing Products Cheap Price - Xingzhichen,China Supply Custom Feed Grade Rice Protein Products Cheap Price - Huge Roc,China Supply Custom New Style Foldaway Plastic Storage Box Products Cheap Price - Zhongyi Plastic Technology Co.Wholesale CE High Quality Power Cable Manufacturers Products Cheap Price - FOD Electrical Engineering, recurrence rates,Wholesale CE High Quality Lid Attached Plastic Crate Products Cheap Price - Zhongyi Plastic Technology Co.,Ltd..China Supply Custom Pvc Mesh Products Cheap Price - Bluekin Industries Limited,China Supply Custom Rheumatism Adhesive Pain Relief Plaster Factories & Manufacturers Pricelist - Xingzhichen

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 Cheap OEM/ODM Lcd Nail Dryer Lamp Products Cheap Price - LONGBON INTERNATIONAL INDUSTRYLtd.;Wholesale CE High Quality Bathroom Mat Suppliers & Manufacturers Quotes - Green Link New Materials Co., Ltd.. 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 Pharmaceutical Modular Cleanroom Suppliers & Manufacturers Quotes - FOD Electrical Engineering,Block Foaming Agent

Radiofrequency ablation

Wholesale CE High Quality Carpet Synthetic Turf Products Cheap Price - Green Link New Materials Co., Ltd.; 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,Wholesale Cheap OEM/ODM Biological Dressing Products Cheap Price - Xingzhichen.

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 Carbon Steel Parts Products Cheap Price - Fenghe,Supply OEM Custom Vitamin B Complex Capsules Products Cheap Price - KeMing Medicines,China Supply Custom Rice Protein Isolated Suppliers & Manufacturers Quotes - Huge Roc

Foam sclerotherapy

Wholesale CE High Quality Aluminum Die Casting Mold Factories & Manufacturers Pricelist - Highpoint Machinery; it can be undertaken in the outpatient clinic,China Supply Custom Foam Sprayer Factory & Supplier Price - Mingou.Wholesale Cheap OEM/ODM Children Foam Toys Products Cheap Price - Unionrise I&EObservational studies found that success rates vary from 82% to 100%,China Mgsr20 Master AlloysWholesale CE High Quality Inexpensive Bookshelves Suppliers & Manufacturers Quotes - INNOVATIVE. 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 Alginate Fiber Wound Dressings Products Cheap Price - Xingzhichen). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.China Supply Custom V Protein Powder Suppliers & Manufacturers Quotes - Huge Roc

An external file that holds a picture, illustration, etc. Object name is i0020-8868-100-1-185-f01.jpg

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 Cheap OEM/ODM Lecithin Supplement Products Cheap Price - Huge Roc,Supply OEM Custom Phone Case 4.7 Inch Products Cheap Price - Shenzhen Hxs Technology

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Wholesale Cheap OEM/ODM Corrugated Roofing Nails Products Cheap Price - Bluekin Industries Limited. 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 Automatic Motor Assembly Line Factories & Manufacturers Pricelist - Ningbo Nide Mechanical Equipment Co., Ltd.,Supply OEM Custom Soft Annealed Iron Wire Factories & Manufacturers Pricelist - Bluekin Industries Limited.Supply OEM Custom Storage Pallets For Sale Products Cheap Price - INNOVATIVEWholesale CE High Quality Duckback Hot Water Bag Factory & Supplier Price - Jade Rabbit Electrical Appliance.Wholesale CE High Quality Sun9s Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRY.Supply OEM Custom Epoxy Coating Machine Factories & Manufacturers Pricelist - Ningbo Nide Mechanical Equipment Co., Ltd..Wholesale Cheap OEM/ODM Resistant Ptfe Wire Suppliers & Manufacturers Quotes - FOD Electrical Engineering.China Supply Custom Football Door Mats Suppliers & Manufacturers Quotes - Green Link New Materials Co., Ltd.. External valvuloplasty, such as external vein valve wrapping,Supply OEM Custom Wooden Shelving Systems Products Cheap Price - INNOVATIVE. Ltd.It aims to increase the coating surface and restore valve competency by external supportWholesale CE High Quality Ivermectin Injection 1% Veterinary Medicine Products Cheap Price - KeMing Medicinesand has not gained large popularity due to its efficacy. However,China Supply Custom Hand Warmer Gloves Factories & Manufacturers Pricelist - Jade Rabbit Electrical Appliance.China Supply Custom Non-Galvanized Welded Wire Mesh Factory & Supplier Price - Bluekin Industries Limited

Overall, all management modalities appear to be safe and effective in the short term and midterm,National BearingSupply OEM Custom Nail Polish Factory Factories & Manufacturers Pricelist - Bluekin Industries Limited.Wholesale Cheap OEM/ODM Flexible Hose Factory & Supplier Price - Mingou;Wholesale Cheap OEM/ODM Chocolate Brown Rice Protein Powder Factory & Supplier Price - Huge Roc. FS was associated with the highest failure rate.Supply OEM Custom Standard Custom Five Axis Reciprocating Machine With Four Plates Factory & Supplier Price - FOD Electrical Engineering,Wholesale CE High Quality Hair Curler Suppliers Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRYHowever, high-Supply OEM Custom Antibiotic Products Cheap Price - KeMing Medicines-term follow-China Supply Custom Very High Fiber Foods Factories & Manufacturers Pricelist - Huge Roc.

Acknowledgments

The first three authors (FL, YS, SZ) contributed equally to this article.

References

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