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

China Supply Custom Self Service Car Wash Equipment Suppliers & Manufacturers Quotes - Mingou. 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 Private Label Dietary Fibers Factory & Supplier Price - Huge Roc.China Supply Custom Pet Protein Factories & Manufacturers Pricelist - Huge Roc.Wholesale Cheap OEM/ODM Furry Hot Water Bottle Factories & Manufacturers Pricelist - Jade Rabbit Electrical Appliance.Supply OEM Custom Stone Cage Wire Mesh Suppliers & Manufacturers Quotes - Bluekin Industries Limited.

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 Organic Pea Protein Powder 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 Price Of Isolated Soy Protein Suppliers & Manufacturers Quotes - Huge Roc–China Supply Custom Automated Conveyor System Products Cheap Price - FOD Electrical EngineeringHigh 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 Slimming Dietary Fiber Suppliers & Manufacturers Quotes - Huge Roc(EVLA),Supply OEM Custom Nested Plastic Crates Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd.(RFA), foam sclerotherapy (FS),China Supply Custom Coating Masking Jig Factories & Manufacturers Pricelist - FOD Electrical Engineering.Wholesale Cheap OEM/ODM Sleep Mask Products Cheap Price - Xingzhichen–m.foneng.net

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).Supply OEM Custom Tpu Iphone 6 Case Products Cheap Price - Shenzhen Hxs TechnologyThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.Wholesale CE High Quality Ivermectin Injection 1% Veterinary Medicine Products Cheap Price - KeMing Medicines. 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 Wheel Loader Suppliers & Manufacturers Quotes - Fenghe).Wholesale CE High Quality Educational Games Products Cheap Price - Unionrise I&EWholesale Cheap OEM/ODM Burn Dressing Factories & Manufacturers Pricelist - Xingzhichen.Wholesale Cheap OEM/ODM Organic Sprouted Brown Rice Products Cheap Price - Huge Roc,Cell CultureWholesale CE High Quality Tablets Antibiotic Medicine Factory & Supplier Price - KeMing Medicines; 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 Plastic Cap Roofing Nails Factories & Manufacturers Pricelist - Bluekin Industries Limited.

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 CE High Quality Vitamin D Tablets Factory & Supplier Price - KeMing Medicines,Wholesale Cheap OEM/ODM Farm Guard Field Fence Factory & Supplier Price - Bluekin Industries LimitedSymptomatic patients with C2 to C6 diseases are indicated for management,Wholesale CE High Quality Hair Curler Suppliers Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY, superficial thrombophlebitis, and bleeding.

Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.China Supply Custom Cheap Whey Protein Isolate Factory & Supplier Price - 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,www.nsen-valve.combecause 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 CE High Quality Portable Nail Drill Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY, and early surgery in uncomplicated veins will not prevent the development of future varicosities.

Supply OEM Custom Dinosaur Hot Water Bottle Suppliers & Manufacturers Quotes - Jade Rabbit Electrical Appliance, such as acute DVT,Supply OEM Custom Epoxy Coating Machine Factories & Manufacturers Pricelist - Ningbo Nide Mechanical Equipment Co.pregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,China Supply Custom Die Casting Process Factory & Supplier Price - Highpoint Machinery,China Supply Custom Robot Spray Painting Machine Products Cheap Price - FOD Electrical Engineering,China Supply Custom What Is Whey Protein Isolate Products Cheap 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 Electric Fast Hair Straightener Brush Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRYThe 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.Supply OEM Custom Lowes Fence Post Suppliers & Manufacturers Quotes - Bluekin Industries LimitedIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (Wholesale Cheap OEM/ODM Die Casting Auto Parts Factory & Supplier Price - Highpoint Machinery). And massive bleeding due to injury to femoral veins,China Supply Custom Food Addtivies Calcium Propionate Products Cheap Price - Huge Roc, 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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China Supply Custom Stator Testing Machine Factories & Manufacturers Pricelist - Ningbo Nide Mechanical Equipment Co., Ltd.; these belong to the category of minimally invasive catheter-based procedures.China Supply Custom Imd Phone Case Suppliers Factory & Supplier Price - Shenzhen Hxs TechnologyIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.China Supply Custom Ammonia Baking Soda Factories & Manufacturers Pricelist - Huge Roc. Alternatively,Supply OEM Custom Dihydroartemisinin Products Cheap Price - KeMing Medicines.Wholesale Cheap OEM/ODM Embossed Aluminum Coil Factories & Manufacturers Pricelist - Shuanglin Jiate Metal Technology.Wholesale CE High Quality Disposable Printed Face Mask Products Cheap Price - Xingzhichen

Supply OEM Custom High Fiber Grains 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.Wholesale Cheap OEM/ODM Car Wash Foam Machine Products Cheap Price - Mingou,China Supply Custom Best Tasting Rice Protein Factories & Manufacturers Pricelist - Huge Roc,6006 BearingsSupply OEM Custom Radiant Heater Factory & Supplier Price - FOD Electrical Engineering, recurrence rates,Wholesale Cheap OEM/ODM Salon Disinfections Machine Factory & Supplier Price - LONGBON INTERNATIONAL INDUSTRY.China Supply Custom Electronic Hair Straightener Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY,China Supply Custom Farm Fence Products Cheap Price - Bluekin Industries Limited

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 Sun Nail Dryer Lamp Factory & Supplier Price - LONGBON INTERNATIONAL INDUSTRYSupply OEM Custom Welded Metal Mesh Factories & Manufacturers Pricelist - Bluekin Industries Limited;China Supply Custom Cheap Small Plastic Containers Factory & Supplier Price - Zhongyi Plastic Technology 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 CE High Quality Synthetic Plant Products Cheap Price - Green Link New Materials Co.,Tri-Ply Cookware With Copper Outside

Radiofrequency ablation

Wholesale Cheap OEM/ODM Warehouse Pallet Racking Systems Factory & Supplier Price - INNOVATIVE; 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 Artificial Roses Leaf Factories & Manufacturers Pricelist - Green Link New Materials 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 Calcium Supplements Factory & Supplier Price - Huge Roc,Wholesale CE High Quality Phone Case For Sale Factories & Manufacturers Pricelist - Shenzhen Hxs Technology,Supply OEM Custom Custom Plastic Storage Crate Products Cheap Price - Zhongyi Plastic Technology Co.

Foam sclerotherapy

Wholesale CE High Quality Kids Hot Water Bottle Factories & Manufacturers Pricelist - Jade Rabbit Electrical Appliance; it can be undertaken in the outpatient clinic,China Supply Custom Imd Phone Case Suppliers Factory & Supplier Price - Shenzhen Hxs Technology.Supply OEM Custom Galvanized Nails For Nail Gun Factory & Supplier Price - Bluekin Industries LimitedObservational studies found that success rates vary from 82% to 100%,Wholesale Cheap OEM/ODM Benzoyl Metronidazole Oral Suspension Factory & Supplier Price - KeMing MedicinesSupply OEM Custom Artesunate Factories & Manufacturers Pricelist - KeMing Medicines. 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 (Supply OEM Custom Light Duty Cantilever Rack Factory & Supplier Price - INNOVATIVE). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Supply OEM Custom Non Gmo Soy Lecithin 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. Ltd.,Supply OEM Custom Pt1000 Fuhler Factories & Manufacturers Pricelist - FOD Electrical Engineering

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China Supply Custom Ptfe Wire For Sensor Applications Ul 1180 Factory & Supplier Price - FOD Electrical Engineering. 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 Animal Protein Concentrate Products Cheap Price - Huge Roc,Wholesale Cheap OEM/ODM Gi Binding Wire Suppliers & Manufacturers Quotes - Bluekin Industries Limited.Supply OEM Custom Radiant Heater Factory & Supplier Price - FOD Electrical EngineeringWholesale Cheap OEM/ODM Vitamin D Capsules Factory & Supplier Price - KeMing Medicines.Wholesale CE High Quality 18 Gauge Binding Wire Specifications Suppliers & Manufacturers Quotes - Bluekin Industries Limited.Wholesale Cheap OEM/ODM Organic Pea Powder Factory & Supplier Price - Huge Roc.Wholesale Cheap OEM/ODM Green Grass Carpet Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd..Wholesale Cheap OEM/ODM 1 1/4 Steel Strapping Suppliers & Manufacturers Quotes - Bluekin Industries Limited. External valvuloplasty, such as external vein valve wrapping,Wholesale Cheap OEM/ODM Final Forming Machine Factories & Manufacturers Pricelist - Ningbo Nide Mechanical Equipment Co., Ltd..Supply OEM Custom Food Additives Sweeteners Products Cheap Price - Huge RocIt aims to increase the coating surface and restore valve competency by external supportWholesale CE High Quality Teflon 30awg Wire Products Cheap Price - FOD Electrical Engineeringand has not gained large popularity due to its efficacy. However,China Supply Custom Children Plastic Slide For Outdoor Amusement Park Factory & Supplier Price - Shanghai Mutong Toys.Supply OEM Custom Metro Wire Shelving Products Cheap Price - INNOVATIVE

Overall, all management modalities appear to be safe and effective in the short term and midterm,Mexican Electric SprayerChina Supply Custom Lotion Emulsifying Machine Factories & Manufacturers Pricelist - Huge Roc.Wholesale CE High Quality Medical Cold Compresses Factory & Supplier Price - Xingzhichen;Supply OEM Custom Painless Dressing Products Cheap Price - Xingzhichen. FS was associated with the highest failure rate.Wholesale CE High Quality Multi Color Nail Drill Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY,Supply OEM Custom Commutator Fusing Machine Suppliers & Manufacturers Quotes - Ningbo Nide Mechanical Equipment Co.However, high-Supply OEM Custom Mobile Shelves Factory & Supplier Price - INNOVATIVE-term follow-Wholesale CE High Quality Breast Sticker Cup Injection Molding Machine Factories & Manufacturers Pricelist - FOD Electrical Engineering.

Acknowledgments

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

References

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