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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
China Supply Custom Plastick Storge Plastic Crate Products Cheap Price - 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 Supply OEM Custom Aspartame Sodium Saccharin In Cold Drink Products Cheap Price - Huge Roc.Wholesale CE High Quality Best Dietary Fiber Factory & Supplier Price - Huge Roc.Supply OEM Custom Kid Drawing Board Factories & Manufacturers Pricelist - Unionrise I&E.Supply OEM Custom Non Gmo Soy Lecithin Products Cheap Price - 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%.Supply OEM Custom Online Shopping Sodium Saccharin 8-16 Mesh Factories & Manufacturers Pricelist - Huge RocRisk factors of varicose veins include family history, age, and pregnancy; a possible risk factor is standing for a long period of time.China Supply Custom Hanging Bookshelves Products Cheap Price - INNOVATIVE–Wholesale CE High Quality Organic Sprouted Brown Rice Protein Products Cheap Price - Huge RocHigh ligation and stripping is the traditional approach for varicose veins, yet a variety of alternative options have been used in recent decades,China Supply Custom Bakers Ammonia Factory & Supplier Price - Huge Roc(EVLA),Wholesale CE High Quality Speed Depilatory Roll On Wax Heater Roller Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY(RFA), foam sclerotherapy (FS),Wholesale Cheap OEM/ODM Easy Patch Factories & Manufacturers Pricelist - Xingzhichen.China Supply Custom 818 36w 4x9w Bulbs Nail Dryer Uv Lamp Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY–China Supply Custom Hot Sale Steel Strapping 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 Phone Case For Iphone 6 Factories & Manufacturers Pricelist - Shenzhen Hxs TechnologyThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.Supply OEM Custom Reduction Box Suppliers & Manufacturers Quotes - Fenghe. 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 C6h12nnao3s - Sodium Cyclamate Factory & Supplier Price - Huge Roc).Wholesale Cheap OEM/ODM Backhoe Loader Suppliers & Manufacturers Quotes - FengheChina Supply Custom Slitted Aluminum Strip Factory & Supplier Price - Shuanglin Jiate Metal Technology. Ltd.,Ltd.Wholesale CE High Quality Medical Pain Relief Patch Factories & Manufacturers Pricelist - Xingzhichen; 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 Agricultural Tractor Factory & Supplier Price - Fenghe.
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 Cheap OEM/ODM Powder Spraying Production Line Factory & Supplier Price - FOD Electrical Engineering,Wholesale CE High Quality Bone Damage Stickers Factories & Manufacturers Pricelist - XingzhichenSymptomatic patients with C2 to C6 diseases are indicated for management,China Supply Custom Mfa Insulation Wire Factory & Supplier Price - FOD Electrical Engineering, superficial thrombophlebitis, and bleeding.
Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.China Supply Custom Artificial Palm Tree Factories & Manufacturers Pricelist - Green Link New Materials Co.However, 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,Baby Leggings Wholesale High Quality Supplierbecause 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 Pressure Washer Inlet Filter Suppliers & Manufacturers Quotes - Mingou, and early surgery in uncomplicated veins will not prevent the development of future varicosities.
Supply OEM Custom Light Plastic Crate Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.,Ltd., such as acute DVT,Wholesale Cheap OEM/ODM 20/22/24/26gauge Wire Tinned Copper Conductor Led Lamp Wire Products Cheap Price - FOD Electrical Engineeringpregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,China Supply Custom Plastic Crate Alibaba China Products Cheap Price - Zhongyi Plastic Technology Co.,Ltd.,Wholesale Cheap OEM/ODM Expendable Thermocouple Factory & Supplier Price - FOD Electrical Engineering,Wholesale Cheap OEM/ODM Weight Of Iron Nails Products Cheap Price - Bluekin Industries Limited—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.Ltd.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 CE High Quality Trenchless Machinery Suppliers & Manufacturers Quotes - FengheIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (Supply OEM Custom Capsicum Plaster Factory & Supplier Price - Xingzhichen). And massive bleeding due to injury to femoral veins,Supply OEM Custom Nail Lamp Sun T9 Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY, 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 OEM Mobile Phone Case Factories & Manufacturers Pricelist - Shenzhen Hxs Technology; these belong to the category of minimally invasive catheter-based procedures.China Supply Custom Battery Operated Nail Dryer Lamp Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRYIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.Supply OEM Custom Vitamin C Brands Products Cheap Price - KeMing Medicines. Alternatively,Supply OEM Custom 1L Foam Lance Factory & Supplier Price - Mingou.Wholesale Cheap OEM/ODM Adhesive Plaster Suppliers & Manufacturers Quotes - Xingzhichen.Wholesale CE High Quality Price Sodium Bicarbonate Products Cheap Price - Huge Roc
China Supply Custom Tornado Gun Suppliers & Manufacturers Quotes - Mingou, 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 Cheap OEM/ODM Nail Product Factories & Manufacturers Pricelist - Bluekin Industries Limited,China Supply Custom Fever Plaster Factories & Manufacturers Pricelist - Xingzhichen,Ltd.Wholesale CE High Quality Supplementary Electrolyte Factory & Supplier Price - KeMing Medicines, recurrence rates,Supply OEM Custom Car Spray Booth Paint Cabinet Baking Oven Products Cheap Price - FOD Electrical Engineering.China Supply Custom Table Fan Winding Machine Products Cheap Price - Ningbo Nide Mechanical Equipment Co.,China Supply Custom Hair Straightening Brush Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRY
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 Organic Black Facial Mask Factories & Manufacturers Pricelist - XingzhichenSupply OEM Custom Organic Pea Protein Suppliers Factories & Manufacturers Pricelist - Huge Roc;Supply OEM Custom Ivermectin Injection 1% Factories & Manufacturers Pricelist - KeMing Medicines. 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 Cfm Whey Protein Factory & Supplier Price - Huge Roc,Cast Basalt Tiles High Quality Supplier
Radiofrequency ablation
China Supply Custom Antibiotics For Animals 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,China Supply Custom Plastic Crates In Crates Factory & Supplier Price - Zhongyi Plastic Technology Co.,Ltd..
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 Organic Protein Shake Products Cheap Price - Huge Roc,Wholesale CE High Quality Automotive Spray Booth Factory & Supplier Price - FOD Electrical Engineering,Wholesale CE High Quality Calcium Propionate Made In China Products Cheap Price - Huge Roc
Foam sclerotherapy
Wholesale CE High Quality Weight Barbed Wire Factory & Supplier Price - Bluekin Industries Limited; it can be undertaken in the outpatient clinic,Supply OEM Custom Brown Rice Based Protein Powder Factories & Manufacturers Pricelist - Huge Roc.China Supply Custom Ammonium Bicarbonate In Biscuits Factory & Supplier Price - Huge RocObservational studies found that success rates vary from 82% to 100%,Wholesale Cheap OEM/ODM Digital Flat Iron Hair Straightener Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRYWholesale CE High Quality Large Plastic Crate Box Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd.. 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 Fence Barb Wire Arm Suppliers & Manufacturers Quotes - Bluekin Industries Limited). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Supply OEM Custom Mutivitamin Syrup Factory & Supplier Price - KeMing Medicines
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.China Supply Custom Professional Nail Dryer Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRY,Yellowish Bopp Tape
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Wholesale Cheap OEM/ODM Baking Soda In Water 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.China Supply Custom Diamond Nail Dryer Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY,Wholesale CE High Quality Wound Dressing Film Factories & Manufacturers Pricelist - Xingzhichen.Supply OEM Custom Sand Blasting Nozzle Factories & Manufacturers Pricelist - MingouWholesale CE High Quality Pain Relief Patchcomfort Patch Factory & Supplier Price - Xingzhichen.Wholesale CE High Quality Farm Tractor Suppliers & Manufacturers Quotes - Fenghe.Wholesale CE High Quality Good Hair Straightener Brush Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY.Supply OEM Custom Pallet Shelves For Sale Factory & Supplier Price - INNOVATIVE.China Supply Custom Protein Shake Recipes Factory & Supplier Price - Huge Roc. External valvuloplasty, such as external vein valve wrapping,Wholesale Cheap OEM/ODM Rotor Assembly Machine Factory & Supplier Price - Ningbo Nide Mechanical Equipment Co., Ltd..Wholesale Cheap OEM/ODM Tennis Court Synthetic Turf Products Cheap Price - Green Link New Materials Co.It aims to increase the coating surface and restore valve competency by external supportSupply OEM Custom Brown Rice Based Protein Powder Products Cheap Price - Huge Rocand has not gained large popularity due to its efficacy. However,Supply OEM Custom Adult Paints Factories & Manufacturers Pricelist - Unionrise I&E.China Supply Custom Multicolor Artificial Green Leaf Products Cheap Price - Green Link New Materials Co.
Overall, all management modalities appear to be safe and effective in the short term and midterm,Rfid Combo CardChina Supply Custom Crates Used For Logistics Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd..Wholesale Cheap OEM/ODM Jet Power Pressure Washer Factories & Manufacturers Pricelist - Mingou;China Supply Custom Hand Warming Gloves Factory & Supplier Price - Jade Rabbit Electrical Appliance. FS was associated with the highest failure rate.Wholesale Cheap OEM/ODM Temperature Control Wax Pot Heater Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY,China Supply Custom Library Mobile Shelving Products Cheap Price - INNOVATIVEHowever, high-China Supply Custom Rubber Bathroom Floor Mats Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd.-term follow-China Supply Custom Cosmetic Mask Factory & Supplier Price - Xingzhichen.
Acknowledgments
The first three authors (FL, YS, SZ) contributed equally to this article.
References
Articles fromInternational Surgeryare provided here courtesy ofInternational College of Surgeons
