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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 Synthetic Plant Products Cheap Price - Green Link New Materials 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 China Supply Custom Neural Relaxation Patch Products Cheap Price - Xingzhichen.China Supply Custom Flowers Artificial Products Cheap Price - Green Link New Materials Co., Ltd..China Supply Custom Good Wax Warmer Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRY.Wholesale Cheap OEM/ODM Crochet Hand Warmers Products Cheap Price - Jade Rabbit Electrical Appliance.
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 Mini Nail Dryer Lamp Products Cheap Price - LONGBON INTERNATIONAL INDUSTRYRisk factors of varicose veins include family history, age, and pregnancy; a possible risk factor is standing for a long period of time.Wholesale CE High Quality Embossed Aluminum Sheet Products Cheap Price - Shuanglin Jiate Metal Technology–Wholesale Cheap OEM/ODM Pea Protein Wholesale 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 Antibiotic Ivermectin Factories & Manufacturers Pricelist - KeMing Medicines(EVLA),Wholesale Cheap OEM/ODM Plastic Kids Outdoor Playground Slide Suppliers & Manufacturers Quotes - Shanghai Mutong Toys(RFA), foam sclerotherapy (FS),Wholesale CE High Quality Mica Tape And Fiber Glass Insulating Wire And Cable Factory & Supplier Price - FOD Electrical Engineering.China Supply Custom Lotion Emulsifying Machine Factories & Manufacturers Pricelist - Huge Roc–Assembly Connector
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 Glue &Glitter Glue Factories & Manufacturers Pricelist - Unionrise I&EThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.Wholesale Cheap OEM/ODM Best Sources Of Dietary Fiber Products Cheap Price - 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 Vitamin Ad3e Injection Products Cheap Price - KeMing Medicines).Wholesale CE High Quality Sun9s Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRYWholesale Cheap OEM/ODM Professional Hair Straightener Factory & Supplier Price - LONGBON INTERNATIONAL INDUSTRY.Wholesale CE High Quality Oem Hair Straightener Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRY,Supply OEM Custom Large Plastic Containers Products Cheap Price - Zhongyi Plastic Technology Co.Supply OEM Custom Agriculture Plastic Tote Products Cheap Price - Zhongyi Plastic Technology Co.,Ltd.; 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 Clotrimazole Products Cheap Price - KeMing Medicines.
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 CE High Quality Vitamin E Capsules Products Cheap Price - KeMing Medicines,China Supply Custom Mobile Phone Case Suppliers Factories & Manufacturers Pricelist - Shenzhen Hxs TechnologySymptomatic patients with C2 to C6 diseases are indicated for management,China Supply Custom Sodium Cyclamate Manufacturernate Products Cheap Price - Huge Roc, superficial thrombophlebitis, and bleeding.
Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.Wholesale CE High Quality Hot Sale Isolated Soy Protein Suppliers & Manufacturers Quotes - 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,Cotton Dyes Manufacturers Cheap Pricebecause 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 Mezzanine Level Suppliers & Manufacturers Quotes - INNOVATIVE, and early surgery in uncomplicated veins will not prevent the development of future varicosities.
Wholesale Cheap OEM/ODM Timber Shelves Factories & Manufacturers Pricelist - INNOVATIVE, such as acute DVT,Wholesale CE High Quality Lead Head Nail Suppliers & Manufacturers Quotes - Bluekin Industries Limitedpregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,China Supply Custom Carbon Steel Parts Products Cheap Price - Fenghe,Wholesale CE High Quality Automatic Metal Parts Powder Coating Line Factories & Manufacturers Pricelist - FOD Electrical Engineering,Wholesale Cheap OEM/ODM Led Nail Uv Lamp Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY—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 CE High Quality Slimming Dietary Fiber Suppliers & Manufacturers Quotes - Huge RocThe 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 Mezzanine Level Suppliers & Manufacturers Quotes - INNOVATIVEIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (China Supply Custom Raw Brown Rice Protein Suppliers & Manufacturers Quotes - Huge Roc). And massive bleeding due to injury to femoral veins,China Supply Custom hydrocolloid dressing Factories & Manufacturers Pricelist - Xingzhichen, 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 Ammonium Bicarbonate Vegan Suppliers & Manufacturers Quotes - Huge Roc; these belong to the category of minimally invasive catheter-based procedures.Wholesale Cheap OEM/ODM Best Sources Of Dietary Fiber Products Cheap Price - Huge RocIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.Wholesale Cheap OEM/ODM Stationary Type Five Axis Reciprocating Machine Suppliers & Manufacturers Quotes - FOD Electrical Engineering. Alternatively,Wholesale Cheap OEM/ODM Chemical Formula Of Ammonium Bicarbonate Suppliers & Manufacturers Quotes - Huge Roc.Supply OEM Custom Vitamin B Complex Capsules Suppliers & Manufacturers Quotes - KeMing Medicines.Wholesale Cheap OEM/ODM Duckback Hot Water Bag Factory & Supplier Price - Jade Rabbit Electrical Appliance
China Supply Custom Soybean Dietary Fibre Factories & Manufacturers Pricelist - 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 Crochet Hand Warmers Products Cheap Price - Jade Rabbit Electrical Appliance,Wholesale Cheap OEM/ODM Expendable Thermocouple Factory & Supplier Price - FOD Electrical Engineering,2.5mm Pitch Header ConnectorWholesale CE High Quality Fiber Diet Chart Suppliers & Manufacturers Quotes - Huge Roc, recurrence rates,Wholesale Cheap OEM/ODM Foldable Plastic Crat Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd..Wholesale Cheap OEM/ODM Bird Cage Welded Wire Mesh Roll Suppliers & Manufacturers Quotes - Bluekin Industries Limited,China Supply Custom Painting & Colouring Sets Suppliers & Manufacturers Quotes - Unionrise I&E
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 CE High Quality Soy Milk Protein Factories & Manufacturers Pricelist - Huge RocSupply OEM Custom Wooden Shelving Systems Products Cheap Price - INNOVATIVE;Wholesale CE High Quality Industrial Extension Wire Suppliers & Manufacturers Quotes - FOD Electrical Engineering. 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 Electric Pressure Washer Factory & Supplier Price - Mingou,Hex Socket Bolt
Radiofrequency ablation
Wholesale CE High Quality Cheap Materials For Nail Factory & Supplier 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,China Supply Custom Baling Steel Strapping 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.Supply OEM Custom Nutribiotic Rice Protein Suppliers & Manufacturers Quotes - Huge Roc,Wholesale Cheap OEM/ODM Best Sources Of Fiber In Food Products Cheap Price - Huge Roc,Supply OEM Custom Soybeans Protein Products Cheap Price - Huge Roc
Foam sclerotherapy
Wholesale Cheap OEM/ODM Folding Jib Aerial Working Vehicle Suppliers & Manufacturers Quotes - Fenghe; it can be undertaken in the outpatient clinic,Supply OEM Custom Plastic Storage Basket Factory & Supplier Price - Zhongyi Plastic Technology Co.,Ltd..China Supply Custom Wooden Slatted Shelves Products Cheap Price - INNOVATIVEObservational studies found that success rates vary from 82% to 100%,Supply OEM Custom Boots Hand Warmers Factories & Manufacturers Pricelist - Jade Rabbit Electrical ApplianceWholesale CE High Quality Vegetable Protein Isolate Products Cheap Price - Huge Roc. 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 Sodium Saccharin Food Grade Products Cheap Price - Huge Roc). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Wholesale Cheap OEM/ODM Herbal Plaster Suppliers & Manufacturers Quotes - Xingzhichen
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 CE High Quality Muscle Protein Powder Suppliers & Manufacturers Quotes - Huge Roc,High Rise Steel Structure Building
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Wholesale Cheap OEM/ODM Hand Warmer Packs Factory & Supplier Price - Jade Rabbit Electrical Appliance. 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.Supply OEM Custom Automotive Spray Booth Suppliers & Manufacturers Quotes - FOD Electrical Engineering,Wholesale CE High Quality Calcium Propionate Uses Factories & Manufacturers Pricelist - Huge Roc.Wholesale CE High Quality Inexpensive Bookshelves Suppliers & Manufacturers Quotes - INNOVATIVEWholesale CE High Quality Best Pea Protein Powder For Weight Loss Suppliers & Manufacturers Quotes - Huge Roc.Supply OEM Custom Nested And Plastic Box Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd..China Supply Custom Vitamin B Complex Syrup Factory & Supplier Price - KeMing Medicines.Wholesale Cheap OEM/ODM Natural Soya Bean Lecithin Suppliers & Manufacturers Quotes - Huge Roc.Wholesale Cheap OEM/ODM Vitamin Ad3e Injection Products Cheap Price - KeMing Medicines. External valvuloplasty, such as external vein valve wrapping,Wholesale CE High Quality Fire Resistant Cable Suppliers & Manufacturers Quotes - FOD Electrical Engineering.Ltd.It aims to increase the coating surface and restore valve competency by external support Ltd.and has not gained large popularity due to its efficacy. However,Wholesale CE High Quality Oil Antimalarials Easy To Use Suppliers & Manufacturers Quotes - KeMing Medicines.China Supply Custom Add Sweetness To Beverages Factories & Manufacturers Pricelist - Huge Roc
Overall, all management modalities appear to be safe and effective in the short term and midterm,Wholesale Cheap OEM/ODM Green Pea Protein Powder Products Cheap Price - Huge RocWholesale CE High Quality Pine Shelving Timber Factories & Manufacturers Pricelist - INNOVATIVE.Supply OEM Custom Painting Palette Factories & Manufacturers Pricelist - Unionrise I&E;China Supply Custom Soya Bean Factory & Supplier Price - Huge Roc. FS was associated with the highest failure rate.Supply OEM Custom Mesh 20x20 Suppliers & Manufacturers Quotes - Bluekin Industries Limited,Supply OEM Custom Vitamin B Complex Capsules Suppliers & Manufacturers Quotes - KeMing MedicinesHowever, high-China Supply Custom Galvanized Wire Mesh 2 Mesh 5x5 Suppliers & Manufacturers Quotes - Bluekin Industries Limited-term follow-China Supply Custom Folding Shopping Crate Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.,Ltd..
Acknowledgments
The first three authors (FL, YS, SZ) contributed equally to this article.
References
Articles fromInternational Surgeryare provided here courtesy ofInternational College of Surgeons
