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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
Wholesale CE High Quality Hair Straightener Price Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY. 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 Shelving Timber Suppliers & Manufacturers Quotes - INNOVATIVE.Wholesale Cheap OEM/ODM Customizable Supermarket Shelf Strip Products Cheap Price - Zhongyi Plastic Technology Co.,Ltd..Wholesale Cheap OEM/ODM Powder Spraying Production Line Factory & Supplier Price - FOD Electrical Engineering.Supply OEM Custom Light-Duty Pallet Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.,Ltd..
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 Electric Hot Water Bottle Argos Factories & Manufacturers Pricelist - Jade Rabbit Electrical ApplianceRisk 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 Oem Hair Straightener Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRY–Wholesale CE High Quality Incipio Phone Case Factory & Supplier Price - Shenzhen Hxs TechnologyHigh ligation and stripping is the traditional approach for varicose veins, yet a variety of alternative options have been used in recent decades,Wholesale Cheap OEM/ODM Three Phase Motor Production Machine Factories & Manufacturers Pricelist - Ningbo Nide Mechanical Equipment Co., Ltd.(EVLA),Wholesale Cheap OEM/ODM Phone Case Company Factories & Manufacturers Pricelist - Shenzhen Hxs Technology(RFA), foam sclerotherapy (FS),Wholesale Cheap OEM/ODM Cfm Whey Protein Factory & Supplier Price - Huge Roc.Wholesale CE High Quality Waxed Steel Strap Suppliers & Manufacturers Quotes - Bluekin Industries Limited–Glass Clamp For Railings
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 Cheap OEM/ODM Pea Protein Powder Brands Factory & Supplier Price - Huge RocThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.Wholesale CE High Quality Pea Protein Reviews 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 CE High Quality Best Dietary Fiber Factory & Supplier Price - Huge Roc).Wholesale CE High Quality Karcher Nozzle Factory & Supplier Price - MingouChina Supply Custom Motor Manufacturing Consulting Products Cheap Price - Ningbo Nide Mechanical Equipment Co., Ltd..Supply OEM Custom Replacer Organic Rice Protein Products Cheap Price - Huge Roc,Heading MachineWholesale Cheap OEM/ODM Packaging Steel Strapping Factory & Supplier 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 Lowes Fence Post Suppliers & Manufacturers Quotes - Bluekin Industries Limited.
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 Twisted Nail Products Cheap Price - Bluekin Industries Limited,Wholesale Cheap OEM/ODM Alpha-Phosphatidyl Choline Factory & Supplier Price - Huge RocSymptomatic patients with C2 to C6 diseases are indicated for management,China Supply Custom Tinned Copper Wire Suppliers & Manufacturers Quotes - FOD Electrical Engineering, superficial thrombophlebitis, and bleeding.
Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.Wholesale Cheap OEM/ODM Corrugated Roofing Nails Products Cheap Price - Bluekin Industries LimitedHowever, 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 Cheap OEM/ODM High Tensile Steel Strapping Factories & Manufacturers Pricelist - Bluekin Industries Limitedbecause the dilated varicose veins usually disappeared without further surgical treatment. It is not indicated to perform thrombectomy for superficial thrombosis in great saphenous veins.China Supply Custom Wheel Loader Suppliers & Manufacturers Quotes - Fenghe, and early surgery in uncomplicated veins will not prevent the development of future varicosities.
Wholesale CE High Quality Plastic Kids Outdoor Playground Slide Factory & Supplier Price - Shanghai Mutong Toys, such as acute DVT,China Supply Custom Mezzanine Staircase Factory & Supplier Price - INNOVATIVEpregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,Wholesale Cheap OEM/ODM Diabetic Foot Dressing Suppliers & Manufacturers Quotes - Xingzhichen,Wholesale CE High Quality Retail Shop Shelving Factory & Supplier Price - INNOVATIVE,Supply OEM Custom Car Pressure Washer Suppliers & Manufacturers Quotes - Mingou—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 Welding Rod 3.15 Mm Factory & Supplier Price - Bluekin Industries LimitedIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (Supply OEM Custom Galvanized Steel Mesh Products Cheap Price - Bluekin Industries Limited). And massive bleeding due to injury to femoral veins,Wholesale Cheap OEM/ODM Bird Cage Welded Wire Mesh Roll Suppliers & Manufacturers Quotes - Bluekin Industries Limited, 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 CE High Quality Karcher Nozzle Factory & Supplier Price - Mingou; these belong to the category of minimally invasive catheter-based procedures.Wholesale Cheap OEM/ODM Newest Phone Case Factory & Supplier Price - Shenzhen Hxs TechnologyIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.Supply OEM Custom Costco Hand Warmers Factories & Manufacturers Pricelist - Jade Rabbit Electrical Appliance. Alternatively,Wholesale CE High Quality Shelves For Shops Factories & Manufacturers Pricelist - INNOVATIVE.Supply OEM Custom Infusion Stickers Factories & Manufacturers Pricelist - Xingzhichen. Ltd.
Wholesale CE High Quality Modular Wooden Shelving Suppliers & Manufacturers Quotes - INNOVATIVE, 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 K Type Thermocouple Compensation Wire Suppliers & Manufacturers Quotes - FOD Electrical Engineering,Supply OEM Custom Healthcare Plaster Factory & Supplier Price - Xingzhichen,150w Led Warehouse Lighting Factory OEM/ODM ProductWholesale CE High Quality Wound Dressing Kit Suppliers & Manufacturers Quotes - Xingzhichen, recurrence rates,Wholesale CE High Quality Lcd Nail Dryer Lamp Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY.Wholesale CE High Quality Loader-Digger Products Cheap Price - Fenghe,China Supply Custom T Post Galvanized Suppliers & Manufacturers Quotes - 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,Wholesale Cheap OEM/ODM Welded Wire Mesh 9 Gauge Factory & Supplier Price - Bluekin Industries LimitedChina Supply Custom Heavy Duty Cantilever Racking Products Cheap Price - INNOVATIVE;Wholesale Cheap OEM/ODM Tpu Iphone 7 Case Products Cheap Price - Shenzhen Hxs Technology. 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 Antibiotics Lincomycin Hcl Capsule Factories & Manufacturers Pricelist - KeMing Medicines,Damper, Traction Gas Spring
Radiofrequency ablation
China Supply Custom Ammonium Hydrogen Carbonate Msds Suppliers & Manufacturers Quotes - Huge Roc; 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 Non Toxic Bright Soft Pastel Factory & Supplier Price - Unionrise I&E.
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 Warehouse Racking System Suppliers & Manufacturers Quotes - INNOVATIVE,China Supply Custom Pure Gold Collagen Facial Mask Products Cheap Price - Xingzhichen,Wholesale CE High Quality Remove Scar Dressing Suppliers & Manufacturers Quotes - Xingzhichen
Foam sclerotherapy
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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 CE High Quality Brown Rice Protein Supplement Factory & Supplier Price - Huge Roc,2-103l 10k Ohm - 3590s-2-103l Potentiometer
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Wholesale CE High Quality 0 Manufacturer - Isolated Soy Protein Factory & Supplier 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 Cheap OEM/ODM Artist Sketching Metallic Color Pencil Factory & Supplier Price - Unionrise I&E,Wholesale Cheap OEM/ODM Whitening Gel Mask Factory & Supplier Price - Xingzhichen.China Supply Custom Hot Dipped Galvanized Welded Wire Mesh Suppliers & Manufacturers Quotes - Bluekin Industries LimitedChina Supply Custom Etfe Insulated Wire Factories & Manufacturers Pricelist - FOD Electrical Engineering.China Supply Custom Plastic Crate Storage Crates Products Cheap Price - Zhongyi Plastic Technology Co.,Ltd..China Supply Custom Calcium Chloride Factory & Supplier Price - KeMing Medicines.Supply OEM Custom Aluminum Die Casting Machinery Parts Factory & Supplier Price - Highpoint Machinery.Wholesale CE High Quality Welded Gabion Mesh Factories & Manufacturers Pricelist - Bluekin Industries Limited. External valvuloplasty, such as external vein valve wrapping,Wholesale CE High Quality Ammonium Bicarbonate Used For Biscuits Products Cheap Price - Huge Roc.Wholesale Cheap OEM/ODM Protein Shake Nutrition Factory & Supplier Price - Huge RocIt aims to increase the coating surface and restore valve competency by external supportWholesale Cheap OEM/ODM Stranded Conductor Silicone Wire Factories & Manufacturers Pricelist - FOD Electrical Engineeringand has not gained large popularity due to its efficacy. However,Wholesale Cheap OEM/ODM New Design Hair Curler Factory & Supplier Price - LONGBON INTERNATIONAL INDUSTRY.Wholesale CE High Quality Plastic Crates With Cover Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.
Overall, all management modalities appear to be safe and effective in the short term and midterm,Ltd.Supply OEM Custom Organic Brown Rice Protein Powder Suppliers & Manufacturers Quotes - Huge Roc.China Supply Custom Rice Protein Isolated Suppliers & Manufacturers Quotes - Huge Roc;Wholesale Cheap OEM/ODM Best Hand Warmer Factory & Supplier Price - Jade Rabbit Electrical Appliance. FS was associated with the highest failure rate.Wholesale CE High Quality Caesarean Section Dressing Factory & Supplier Price - Xingzhichen,Wholesale Cheap OEM/ODM Face Paint Factory & Supplier Price - Unionrise I&EHowever, high-Wholesale Cheap OEM/ODM Sodium Saccharin Suppliers Products Cheap Price - Huge Roc-term follow-Wholesale Cheap OEM/ODM Antidiarrheal Agent & Supplementary Electrolyte Suppliers & Manufacturers Quotes - KeMing Medicines.
Acknowledgments
The first three authors (FL, YS, SZ) contributed equally to this article.
References
Articles fromInternational Surgeryare provided here courtesy ofInternational College of Surgeons
