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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 Rice Whey Protein Factories & Manufacturers Pricelist - Huge Roc. 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 Bicarbonate Supplement Factory & Supplier Price - Huge Roc.China Supply Custom Craft Glass Block Suppliers & Manufacturers Quotes - Bluekin Industries Limited.Wholesale CE High Quality Top Level Vital Wheat Gluten Factory & Supplier Price - Huge Roc.China Supply Custom Plastic Crates Maker Factories & Manufacturers Pricelist - 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%.China Supply Custom Eagle Wire Shelving Factories & Manufacturers Pricelist - INNOVATIVERisk 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 Hard Drawn Wire Factories & Manufacturers Pricelist - Bluekin Industries Limited–Wholesale CE High Quality Pea Protein Food Ingredients 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 Sodium Bicarbonate Baking Soda Products Cheap Price - Huge Roc(EVLA),Wholesale CE High Quality 2x2 Galvanized Welded Wire Mesh Factory & Supplier Price - Bluekin Industries Limited(RFA), foam sclerotherapy (FS),Wholesale Cheap OEM/ODM Winter Face Mask Factories & Manufacturers Pricelist - Xingzhichen.Wholesale Cheap OEM/ODM 1050 Cooking Aluminum Circle Suppliers & Manufacturers Quotes - Shuanglin Jiate Metal Technology–Chest Press (Dual Movement)
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 Ammonium Bicarbonate Vegan Suppliers & Manufacturers Quotes - Huge RocThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.Supply OEM Custom 5-Bar Aluminum Floor Plates Factory & Supplier Price - Shuanglin Jiate Metal Technology. 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 Protein Shake Recipes Factory & Supplier Price - Huge Roc).Supply OEM Custom Diy Roller Foam Paint Brush Factory & Supplier Price - Unionrise I&EWholesale CE High Quality Plastic Storage Boxes For Storage Clothes Factory & Supplier Price - Zhongyi Plastic Technology Co.,Ltd..Wholesale Cheap OEM/ODM Razor Wire For Sale Suppliers & Manufacturers Quotes - Bluekin Industries Limited,5ml Lipstick TubeChina Supply Custom Electric Motor Housing Suppliers & Manufacturers Quotes - Highpoint Machinery; 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,China Supply Custom White Rice Protein Products Cheap Price - Huge Roc.
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 What Foods Are High In Fiber List Products Cheap Price - Huge Roc,China Supply Custom Thermocouple Compensation Wire Products Cheap Price - FOD Electrical EngineeringSymptomatic patients with C2 to C6 diseases are indicated for management,Wholesale Cheap OEM/ODM Automatic Car Cleaning Machines Suppliers & Manufacturers Quotes - Mingou, superficial thrombophlebitis, and bleeding.
Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.Ltd.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,Wholesale CE High Quality Full Body Hot Water Bottle Suppliers & Manufacturers Quotes - Jade Rabbit Electrical Appliancebecause 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 Vital Wheat Gluten 25kg Wheat Flour Factories & Manufacturers Pricelist - Huge Roc, and early surgery in uncomplicated veins will not prevent the development of future varicosities.
Wholesale Cheap OEM/ODM Antimalarial Suppliers & Manufacturers Quotes - KeMing Medicines, such as acute DVT,Supply OEM Custom 1L Foam Lance Factory & Supplier Price - Mingoupregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,Supply OEM Custom Medical Face Mask Factory & Supplier Price - Xingzhichen,Supply OEM Custom Outdoor Gym Equipemnt Factories & Manufacturers Pricelist - Shanghai Mutong Toys,Wholesale CE High Quality Wire Shelving Parts Factory & Supplier Price - INNOVATIVE—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 White Wooden Shelf Brackets Factory & Supplier Price - INNOVATIVEThe 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 Steel Wire Rope Manufacturer Products Cheap Price - Bluekin Industries LimitedIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (Wholesale Cheap OEM/ODM Wholesale Phone Cases Factories & Manufacturers Pricelist - Shenzhen Hxs Technology). And massive bleeding due to injury to femoral veins,Wholesale Cheap OEM/ODM Anorectal Dressing Products Cheap Price - 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 White Wooden Shelf Brackets Products Cheap Price - INNOVATIVE; these belong to the category of minimally invasive catheter-based procedures.Wholesale CE High Quality Now Sports Pea Protein Factories & Manufacturers Pricelist - Huge RocIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.Wholesale Cheap OEM/ODM 20/22/24/26gauge Wire Tinned Copper Conductor Led Lamp Wire Products Cheap Price - FOD Electrical Engineering. Alternatively,China Supply Custom Electric Pressure Washer Factory & Supplier Price - Mingou.Wholesale Cheap OEM/ODM Calcium Propionate Vegan Products Cheap Price - Huge Roc.Supply OEM Custom Beauty Face Mask Products Cheap Price - Xingzhichen
Supply OEM Custom Timber Shelving Units Factory & Supplier Price - 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 CE High Quality Dubai Wire Factories & Manufacturers Pricelist - Bluekin Industries Limited,Wholesale CE High Quality Fiber Diet Chart Suppliers & Manufacturers Quotes - Huge Roc,3g Wcdma Car Gps Tracker Strong MagnetSupply OEM Custom Multifunction Electric Steamer Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY, recurrence rates,Wholesale CE High Quality China Black Annealed Iron Wire Suppliers & Manufacturers Quotes - Bluekin Industries Limited.Supply OEM Custom Vanilla Rice Protein Products Cheap Price - Huge Roc,Supply OEM Custom Bicarbonate Supplement Factory & Supplier Price - Huge Roc
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 Disposable Printed Face Mask Products Cheap Price - XingzhichenSupply OEM Custom wound dressing making pad Factories & Manufacturers Pricelist - Xingzhichen;Supply OEM Custom China Storage Plastic Crates 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.Supply OEM Custom Soft Annealed Iron Wire Factories & Manufacturers Pricelist - Bluekin Industries Limited,Wholesale Cheap OEM/ODM Calcium Propionate For Sale Suppliers & Manufacturers Quotes - Huge Roc
Radiofrequency ablation
Supply OEM Custom Phone Case Iphone 5c Products Cheap Price - Shenzhen Hxs Technology; 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 Library Mobile Shelving Products Cheap Price - INNOVATIVE.
Currently available clinical trial evidence suggests RFA and EVLA are at least as effective as surgery in the treatment of great saphenous varicose veins.China Supply Custom Good Protein Powder Products Cheap Price - Huge Roc,Wholesale CE High Quality Soy Milk Protein Factories & Manufacturers Pricelist - Huge Roc,Ltd.
Foam sclerotherapy
Wholesale Cheap OEM/ODM Sodium Cyclamate Distributor Products Cheap Price - Huge Roc; it can be undertaken in the outpatient clinic,Wholesale CE High Quality Brown Rice Protein Supplement Factory & Supplier Price - Huge Roc.Wholesale CE High Quality Black Metal Steel Strapping Products Cheap Price - Bluekin Industries LimitedObservational studies found that success rates vary from 82% to 100%,Ergonomic Mesh ChairChina Supply Custom Soya Lecithin Food Grade Factory & Supplier 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 (Wholesale CE High Quality Hair Straightening Brush Suppliers Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Supply OEM Custom Mobile Shelves Factory & Supplier Price - INNOVATIVE
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 4mm Welding Rod Factories & Manufacturers Pricelist - Bluekin Industries Limited,Wholesale Cheap OEM/ODM Childrens Hot Water Bottle Suppliers & Manufacturers Quotes - Jade Rabbit Electrical Appliance
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China Supply Custom Gmp Certified Vitamin C Tablet Products Cheap Price - KeMing Medicines. 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 adhesive wound dressing Factories & Manufacturers Pricelist - Xingzhichen,Supply OEM Custom Single Wire Factories & Manufacturers Pricelist - Bluekin Industries Limited.China Supply Custom Sun9s Nail Light Products Cheap Price - LONGBON INTERNATIONAL INDUSTRYSupply OEM Custom Can Inside Spray Painting Machine Suppliers & Manufacturers Quotes - FOD Electrical Engineering.Wholesale Cheap OEM/ODM Make Up Female Mannequin Factory & Supplier Price - Zhongyi Plastic Technology Co.,Ltd..China Supply Custom Best High Fiber Diet Factory & Supplier Price - Huge Roc.China Supply Custom Antibiotics Oral Suspension Factories & Manufacturers Pricelist - KeMing Medicines.China Supply Custom Table Fan Winding Machine Products Cheap Price - Ningbo Nide Mechanical Equipment Co., Ltd.. External valvuloplasty, such as external vein valve wrapping,Supply OEM Custom Stainless Steel Nozzle Factory & Supplier Price - Mingou.China Supply Custom Facial Mask Factories & Manufacturers Pricelist - XingzhichenIt aims to increase the coating surface and restore valve competency by external supportChina Supply Custom Cooling Stickers Factories & Manufacturers Pricelist - Xingzhichenand has not gained large popularity due to its efficacy. However,Supply OEM Custom Tpu Phone Case Iphone 5s Suppliers & Manufacturers Quotes - Shenzhen Hxs Technology.China Supply Custom Brown Rice Protein Powder Suppliers & Manufacturers Quotes - Huge Roc
Overall, all management modalities appear to be safe and effective in the short term and midterm,Ce Moped Scooter With PedalSupply OEM Custom 98% Soya Lecithin/Soybean Factory & Supplier Price - Huge Roc.Supply OEM Custom Electric Fast Hair Straightener Brush Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY;China Supply Custom Cell Phone Case And Accessories Suppliers & Manufacturers Quotes - Shenzhen Hxs Technology. FS was associated with the highest failure rate.Supply OEM Custom 6x6 Reinforcing Welded Wire Mesh Factories & Manufacturers Pricelist - Bluekin Industries Limited,Supply OEM Custom Antimalarials Factory & Supplier Price - KeMing MedicinesHowever, high-Wholesale Cheap OEM/ODM Pea Protein Wholesale Products Cheap Price - Huge Roc-term follow-Wholesale Cheap OEM/ODM Colored Folding Plastic Containers 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
