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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 Sun9s Factories & Manufacturers Pricelist - 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 Supply OEM Custom Epoxy Coating Machine Factories & Manufacturers Pricelist - Ningbo Nide Mechanical Equipment Co., Ltd..Wholesale Cheap OEM/ODM Resistant Ptfe Wire Suppliers & Manufacturers Quotes - FOD Electrical Engineering.China Supply Custom Football Door Mats Suppliers & Manufacturers Quotes - Green Link New Materials Co., Ltd..Supply OEM Custom Wooden Shelving Systems Products Cheap Price - INNOVATIVE.
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 Organic Soy Lecithin 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.Wholesale Cheap OEM/ODM 99% Artemisinin Products Cheap Price - KeMing Medicines–China Supply Custom Good Wax Warmer Factories & Manufacturers Pricelist - LONGBON INTERNATIONAL INDUSTRYHigh 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 Hand Warmer Gloves Factories & Manufacturers Pricelist - Jade Rabbit Electrical Appliance(EVLA),Supply OEM Custom Nail Polish Factory Factories & Manufacturers Pricelist - Bluekin Industries Limited(RFA), foam sclerotherapy (FS),Wholesale Cheap OEM/ODM Flexible Hose Factory & Supplier Price - Mingou.Wholesale Cheap OEM/ODM Sodium Saccharin Uses Factory & Supplier Price - Huge Roc–Bpc 157 Peptide
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 Zippo Hand Warmer Suppliers & Manufacturers Quotes - Jade Rabbit Electrical ApplianceThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.Wholesale Cheap OEM/ODM Chocolate Brown Rice Protein Powder Factory & Supplier 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 (Ltd.).Wholesale CE High Quality Adhesive Transparent Dressing Products Cheap Price - XingzhichenSupply OEM Custom Antibiotic Products Cheap Price - KeMing Medicines.China Supply Custom Feed Grade Rice Protein Products Cheap Price - Huge Roc,Aluminum Machining PartsChina Supply Custom Very High Fiber Foods Factories & Manufacturers Pricelist - Huge Roc; 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 High Temp Resistant Teflon Wire Suppliers & Manufacturers Quotes - FOD Electrical Engineering.
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.China Supply Custom Rheumatism Adhesive Pain Relief Plaster Factories & Manufacturers Pricelist - Xingzhichen,Ltd.Symptomatic patients with C2 to C6 diseases are indicated for management,Wholesale CE High Quality C6h12nnao3s - Sodium Cyclamate Factory & Supplier Price - Huge Roc, superficial thrombophlebitis, and bleeding.
Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.Wholesale Cheap OEM/ODM Pharmaceutical Modular Cleanroom Suppliers & Manufacturers Quotes - FOD Electrical EngineeringHowever, 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,Sinopec Sichuan Vinylon Works Vam 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.China Supply Custom Chain Link Fence Cage Products Cheap Price - Bluekin Industries Limited, and early surgery in uncomplicated veins will not prevent the development of future varicosities.
China Supply Custom Gold Aluminum Foil Factories & Manufacturers Pricelist - Shuanglin Jiate Metal Technology, such as acute DVT,China Supply Custom Carbon Steel Parts Products Cheap Price - Fenghepregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,Wholesale CE High Quality Kx Thermocouple Wire Factory & Supplier Price - FOD Electrical Engineering,China Supply Custom Fitness Center Products Cheap Price - Green Link New Materials Co., Ltd.,China Supply Custom 6s Phone Case Suppliers & Manufacturers Quotes - Shenzhen Hxs Technology—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 Vitamin B Complex Capsules Products Cheap Price - KeMing MedicinesThe 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.China Supply Custom Rice Protein Isolated Suppliers & Manufacturers Quotes - Huge RocIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (Wholesale Cheap OEM/ODM Children Foam Toys Products Cheap Price - Unionrise I&E). And massive bleeding due to injury to femoral veins,Supply OEM Custom Organic Pea Protein Suppliers Factories & Manufacturers Pricelist - 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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Supply OEM Custom Soy Protein Isolate Cas 9010-10-0 Factory & Supplier Price - Huge Roc; these belong to the category of minimally invasive catheter-based procedures.China Supply Custom Alginate Fiber Wound Dressings Products Cheap Price - XingzhichenIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.China Supply Custom Cutting Edge Factories & Manufacturers Pricelist - Fenghe. Alternatively,Wholesale CE High Quality Plant Based Pea Protein Powder Products Cheap Price - Huge Roc.Wholesale Cheap OEM/ODM Protein Shake Diet Factory & Supplier Price - Huge Roc.China Supply Custom V Protein Powder Suppliers & Manufacturers Quotes - Huge Roc
China Supply Custom Non-Galvanized Welded Wire Mesh Factory & Supplier Price - Bluekin Industries Limited, 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.China Supply Custom Mirror Polished Aluminum Coil Suppliers & Manufacturers Quotes - Shuanglin Jiate Metal Technology,Wholesale Cheap OEM/ODM Lecithin Supplement Products Cheap Price - Huge Roc,Wholesale Cheap OEM/ODM Veterinary Drugs Horses Products Cheap Price - KeMing MedicinesWholesale CE High Quality Copper Conductor Awg Silicone Wire Suppliers & Manufacturers Quotes - FOD Electrical Engineering, recurrence rates,Wholesale Cheap OEM/ODM Karcher K3 Pressure Washer Suppliers & Manufacturers Quotes - Mingou.Supply OEM Custom Storage Pallets For Sale Products Cheap Price - INNOVATIVE, Ltd.
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 High Protein Powder Factories & Manufacturers Pricelist - Huge RocWholesale CE High Quality Ivermectin Injection 1% Veterinary Medicine Products Cheap Price - KeMing Medicines;Supply OEM Custom Sprouted Rice Protein Powder Factory & Supplier Price - Huge Roc. 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 Non-Galvanized Welded Wire Mesh Factory & Supplier Price - Bluekin Industries Limited,Wholesale Cheap OEM/ODM Ammonium Bicarbonate Used For Biscuits Factory & Supplier Price - Huge Roc
Radiofrequency ablation
Wholesale CE High Quality Nail Product Factories & Manufacturers Pricelist - 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,Supply OEM Custom Sodium Saccharin Food Grade Products Cheap Price - Huge Roc.
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 Standard Custom Five Axis Reciprocating Machine With Four Plates Factory & Supplier Price - FOD Electrical Engineering,Wholesale CE High Quality Hair Curler Suppliers Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY,Wholesale Cheap OEM/ODM Hand Warmers Football Factory & Supplier Price - Jade Rabbit Electrical Appliance
Foam sclerotherapy
China Supply Custom Foldaway Crate Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.,Ltd.; it can be undertaken in the outpatient clinic,Wholesale CE High Quality Vitamin Drugs Factories & Manufacturers Pricelist - KeMing Medicines.Wholesale CE High Quality PU dressing Suppliers & Manufacturers Quotes - XingzhichenObservational studies found that success rates vary from 82% to 100%,Wholesale CE High Quality Unique Bookshelves Products Cheap Price - INNOVATIVEWholesale CE High Quality Pressure Washer Hose Adapter Suppliers & Manufacturers Quotes - Mingou. 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 Pallet Warehouse Factories & Manufacturers Pricelist - INNOVATIVE). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Wholesale CE High Quality Inside Spraying Painting Machine Forglass Bottles Suppliers & Manufacturers Quotes - FOD Electrical Engineering
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 Artificial Leaf Craft Factories & Manufacturers Pricelist - Green Link New Materials Co.,Air Dehydrator
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Supply OEM Custom Slip Door Mat Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd.. 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 CE High Quality Emulsifier Lecithin Soy Products Cheap Price - Huge Roc,Supply OEM Custom Multi-Function Plastic Crate With Lid Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd..Wholesale Cheap OEM/ODM Hot Sale Soy Lecithin Factories & Manufacturers Pricelist - Huge RocWholesale CE High Quality Vital Protein Pea Protein Isolate Suppliers & Manufacturers Quotes - Huge Roc.Wholesale Cheap OEM/ODM Car Wash Foam Machine Products Cheap Price - Mingou.China Supply Custom Adjustable Wire Shelving Factories & Manufacturers Pricelist - INNOVATIVE.Wholesale Cheap OEM/ODM Pharmaceutical Modular Cleanroom Suppliers & Manufacturers Quotes - FOD Electrical Engineering.Wholesale Cheap OEM/ODM Antimalarial Factory & Supplier Price - KeMing Medicines. External valvuloplasty, such as external vein valve wrapping,Wholesale CE High Quality Embossed Aluminum Sheet Products Cheap Price - Shuanglin Jiate Metal Technology.Supply OEM Custom Stone Cage Wire Mesh Products Cheap Price - Bluekin Industries LimitedIt aims to increase the coating surface and restore valve competency by external supportWholesale CE High Quality Artificial Roses Leaf Factories & Manufacturers Pricelist - Green Link New Materials Co.and has not gained large popularity due to its efficacy. However,Supply OEM Custom Diclazuril Veterinary Drugs Factories & Manufacturers Pricelist - KeMing Medicines.China Supply Custom Adjustable Wire Shelving Factories & Manufacturers Pricelist - INNOVATIVE
Overall, all management modalities appear to be safe and effective in the short term and midterm,Chinese Epoxy Resin Supplier Manufacturer High Quality SupplierChina Supply Custom Sandwich Panel For Dustless Workshop Ceiling Products Cheap Price - FOD Electrical Engineering.Wholesale CE High Quality Ring Shank Nail Products Cheap Price - Bluekin Industries Limited;China Supply Custom Strand Rc Silicone Wire Factories & Manufacturers Pricelist - FOD Electrical Engineering. FS was associated with the highest failure rate.China Supply Custom Factory & Supplier Price - INNOVATIVE,Ltd.However, high-China Supply Custom Farm Soil Tilling Machine Suppliers & Manufacturers Quotes - Fenghe-term follow-Supply OEM Custom Nature Looking Artificial Turf Products Cheap Price - Green Link New Materials 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
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