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

Wholesale CE High Quality Electric Hot Pack Suppliers & Manufacturers Quotes - Jade Rabbit Electrical Appliance. There are a variety of management modalities for varicose veins. The outcomes of the treatment of varicose veins are different. The papers on Wholesale Cheap OEM/ODM Ceramic Hair Straightening Brush Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY.Wholesale CE High Quality Racking System For Warehouse Products Cheap Price - INNOVATIVE.Wholesale CE High Quality Multi Color Nail Drill Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY.Wholesale CE High Quality Grader Factory & Supplier Price - 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%.China Supply Custom First Aid Wound Dressing Suppliers & Manufacturers Quotes - XingzhichenRisk 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 Motto Barbed Wire Factory & Supplier Price - Bluekin Industries Limited– Ltd.High 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 G1/4 F Snow Foam Lance Factories & Manufacturers Pricelist - Mingou(EVLA),China Supply Custom Factory Wholesale Nail File Drills Factory & Supplier Price - LONGBON INTERNATIONAL INDUSTRY(RFA), foam sclerotherapy (FS),Wholesale Cheap OEM/ODM Sun9c Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY.Wholesale Cheap OEM/ODM Organic Black Facial Mask Factories & Manufacturers Pricelist - Xingzhichen–Supply OEM Custom Handheld Steam Iron Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY

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 Vitamin B9 Products Cheap Price - KeMing MedicinesThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.China Supply Custom Brass Adapter Products Cheap Price - 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 (Wholesale CE High Quality sheet face mask oem Suppliers & Manufacturers Quotes - Xingzhichen).Wholesale CE High Quality Oil Antimalarials Easy To Use Suppliers & Manufacturers Quotes - KeMing MedicinesSupply OEM Custom Metal Parts Products Cheap Price - Fenghe.Supply OEM Custom Aluminum Die Casting Machinery Parts Factory & Supplier Price - Highpoint Machinery,Fabric Raw Material Sponges Manufacturers Cheap PriceWholesale CE High Quality Raw Material Wire Nails Products Cheap Price - Bluekin Industries Limited; 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,Supply OEM Custom Bus Spray Paint Cabinet Suppliers & Manufacturers Quotes - FOD Electrical Engineering.

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.Supply OEM Custom Nichrome Thermocouple Wire Factory & Supplier Price - FOD Electrical Engineering,Wholesale CE High Quality Pharmaceutical Aluminum Foil Factories & Manufacturers Pricelist - Shuanglin Jiate Metal TechnologySymptomatic patients with C2 to C6 diseases are indicated for management,Wholesale Cheap OEM/ODM Pm 2.5 Face Mask Factories & Manufacturers Pricelist - Xingzhichen, superficial thrombophlebitis, and bleeding.

Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.Wholesale Cheap OEM/ODM Hydroxyde Aluminium +Hydroxyde Magnesium Tabs Products Cheap Price - KeMing MedicinesHowever, 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 CE High Quality Ampicillin Suppliers & Manufacturers Quotes - KeMing Medicinesbecause the dilated varicose veins usually disappeared without further surgical treatment. It is not indicated to perform thrombectomy for superficial thrombosis in great saphenous veins.Wholesale Cheap OEM/ODM Crate For Turnover Container Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.,Ltd., and early surgery in uncomplicated veins will not prevent the development of future varicosities.

Wholesale CE High Quality sterile Factory & Supplier Price - Xingzhichen, such as acute DVT,China Supply Custom Cell Phone Case And Accessories Suppliers & Manufacturers Quotes - Shenzhen Hxs Technologypregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,China Supply Custom Hair Straightening Brush Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRY,China Supply Custom Whey Protein Powder For Diabetics Factories & Manufacturers Pricelist - Huge Roc,China Supply Custom Butterfly Suncatcher Suppliers & Manufacturers Quotes - Unionrise I&E—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 Green Grass Carpet Suppliers & Manufacturers Quotes - Green Link New Materials Co.The 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 Cheap OEM/ODM Calcium Propionate Vegan Suppliers & Manufacturers Quotes - Huge RocIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (China Supply Custom Crates Used For Logistics Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.). And massive bleeding due to injury to femoral veins,Supply OEM Custom Metro Wire Shelving Products Cheap 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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Wholesale Cheap OEM/ODM Plaster For Arthritis Pain Relief Products Cheap Price - Xingzhichen; these belong to the category of minimally invasive catheter-based procedures.Supply OEM Custom Face Paint Factories & Manufacturers Pricelist - Unionrise I&EIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.Wholesale Cheap OEM/ODM Wood Shelves For Sale Suppliers & Manufacturers Quotes - INNOVATIVE. Alternatively,Wholesale CE High Quality Automotive Spray Booth Factory & Supplier Price - FOD Electrical Engineering.Wholesale Cheap OEM/ODM Whey Protein Products Factories & Manufacturers Pricelist - Huge Roc.Supply OEM Custom Gold Plated Tungsten Wire Factory & Supplier Price - FOD Electrical Engineering

China Supply Custom Cheap Whey Protein Isolate Factory & Supplier 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.Supply OEM Custom Plaster For Rheumatism Suppliers & Manufacturers Quotes - Xingzhichen,Wholesale CE High Quality Bulk Supply High Quality Soy Protein Isolate Factories & Manufacturers Pricelist - Huge Roc,Wholesale CE High Quality Aluminium Coil Factories & Manufacturers Pricelist - Shuanglin Jiate Metal TechnologyWholesale Cheap OEM/ODM Sodium Saccharin Uses Factory & Supplier Price - Huge Roc, recurrence rates,Wholesale CE High Quality Foot Bath Mat Suppliers & Manufacturers Quotes - Green Link New Materials Co., Ltd..Wholesale CE High Quality Bathroom Mat Suppliers & Manufacturers Quotes - Green Link New Materials Co.,China Supply Custom Cheap Small Plastic Containers Factory & Supplier Price - Zhongyi Plastic Technology Co.

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 Warehouse Pallet Racking Factory & Supplier Price - INNOVATIVEWholesale CE High Quality Barbed Wire Length Per Roll Suppliers & Manufacturers Quotes - Bluekin Industries Limited;Supply OEM Custom Rubber Hose Factory & Supplier Price - 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.Wholesale CE High Quality Tattoo Barbed Wire Products Cheap Price - Bluekin Industries Limited,Charm Necklace

Radiofrequency ablation

Wholesale Cheap OEM/ODM Hanging Conveyor System 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,Wholesale CE High Quality Nails Machine Making Factories & Manufacturers Pricelist - Bluekin Industries Limited.

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 Ammonium Bicarbonate Used For Biscuits Products Cheap Price - Huge Roc,Supply OEM Custom Animal Veterinary Medicine Factory & Supplier Price - KeMing Medicines, Ltd.

Foam sclerotherapy

Wholesale Cheap OEM/ODM Hand Warmers Gloves Products Cheap Price - Jade Rabbit Electrical Appliance; it can be undertaken in the outpatient clinic,Supply OEM Custom Teflon Twin Wire Suppliers & Manufacturers Quotes - FOD Electrical Engineering.Wholesale Cheap OEM/ODM Plaster For Arthritis Pain Relief Products Cheap Price - XingzhichenObservational studies found that success rates vary from 82% to 100%,Coil Nail Production Line Factory OEM/ODM ProductsChina Supply Custom Concrete Steel Nail Factory & Supplier Price - Bluekin Industries Limited. 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 Fiber Supplements Factory & Supplier Price - Huge Roc). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Wholesale Cheap OEM/ODM Organic Rice Protein Powder Products Cheap Price - Huge Roc

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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 Facial Patch Mask Products Cheap Price - Xingzhichen,Cement Flakes Flooring Coating

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Wholesale Cheap OEM/ODM Now Organic Pea Protein 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 Thermocouple Wire Products Cheap Price - FOD Electrical Engineering,Wholesale CE High Quality Teflon 30awg Wire Products Cheap Price - FOD Electrical Engineering.China Supply Custom Organic Whey Protein Powder Factory & Supplier Price - Huge RocWholesale Cheap OEM/ODM Salbutamol Syrup Factory & Supplier Price - KeMing Medicines.China Supply Custom Good Protein Powder Products Cheap Price - Huge Roc.Supply OEM Custom Conference Room Carpet Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd..Supply OEM Custom Food Grade Use Of Ammonium Bicarbonate Suppliers & Manufacturers Quotes - Huge Roc.China Supply Custom Robotic Spray Painting Line Suppliers & Manufacturers Quotes - FOD Electrical Engineering. External valvuloplasty, such as external vein valve wrapping,Wholesale Cheap OEM/ODM Grass Carpet For Garden Products Cheap Price - Green Link New Materials Co., Ltd..Wholesale Cheap OEM/ODM Powder Coating Spray Booth Factory & Supplier Price - FOD Electrical EngineeringIt aims to increase the coating surface and restore valve competency by external supportSupply OEM Custom Organic Pea Protein Powder Bulk Suppliers & Manufacturers Quotes - Huge Rocand has not gained large popularity due to its efficacy. However,Supply OEM Custom Shaft Pressing Machine Factories & Manufacturers Pricelist - Ningbo Nide Mechanical Equipment Co., Ltd..Wholesale Cheap OEM/ODM Thhn Thwn Electrical Wire 16 Awg Suppliers & Manufacturers Quotes - FOD Electrical Engineering

Overall, all management modalities appear to be safe and effective in the short term and midterm,www.ra-tl.comSupply OEM Custom Kid Drawing Board Factory & Supplier Price - Unionrise I&E.China Supply Custom Artificial Light Maple Tree Factory & Supplier Price - Green Link New Materials Co., Ltd.;Wholesale CE High Quality Artificial Leaf Craft Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd.. FS was associated with the highest failure rate.Wholesale Cheap OEM/ODM Oral Injectable Grade Factories & Manufacturers Pricelist - KeMing Medicines,Wholesale CE High Quality Timber Cube Shelves Factory & Supplier Price - INNOVATIVEHowever, high-China Supply Custom Snowing Artificial Christmas Trees Suppliers & Manufacturers Quotes - Green Link New Materials Co., Ltd.-term follow-Supply OEM Custom Unique Bookshelves Factories & Manufacturers Pricelist - INNOVATIVE.

Acknowledgments

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

References

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