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

China Supply Custom Sandwich Panel For Dustless Workshop Ceiling Products Cheap Price - FOD Electrical Engineering. There are a variety of management modalities for varicose veins. The outcomes of the treatment of varicose veins are different. The papers on 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.China Supply Custom Farm Soil Tilling Machine Suppliers & Manufacturers Quotes - Fenghe.Supply OEM Custom Nature Looking Artificial Turf Products Cheap Price - Green Link New Materials 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%.Supply OEM Custom Mesh 20x20 Suppliers & Manufacturers Quotes - Bluekin Industries LimitedRisk 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 Vitamin B Complex Capsules Suppliers & Manufacturers Quotes - KeMing Medicines–China Supply Custom Soybean Dietary Fibre Factories & Manufacturers Pricelist - Huge RocHigh ligation and stripping is the traditional approach for varicose veins, yet a variety of alternative options have been used in recent decades,Supply OEM Custom Mesh 20x20 Suppliers & Manufacturers Quotes - Bluekin Industries Limited(EVLA),China Supply Custom Where Can I Get Sodium Bicarbonate Factories & Manufacturers Pricelist - Huge Roc(RFA), foam sclerotherapy (FS),China Supply Custom Modular Metal Shelving Suppliers & Manufacturers Quotes - INNOVATIVE.Supply OEM Custom Packaging Aluminium Foil Factory & Supplier Price - Shuanglin Jiate Metal Technology–China Supply Custom Ammonium Bicarbonate Tech Grade 99.2%Min Suppliers & Manufacturers Quotes - Huge Roc

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 Karcher K3 Pressure Washer Suppliers & Manufacturers Quotes - MingouThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.China Supply Custom Electric Ir Heater Products Cheap Price - FOD Electrical Engineering. 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 Brand Name Phone Case Factories & Manufacturers Pricelist - Shenzhen Hxs Technology).Wholesale Cheap OEM/ODM Gold Detox Foot Patch Factories & Manufacturers Pricelist - XingzhichenChina Supply Custom Mobile Library Shelving Products Cheap Price - INNOVATIVE.China Supply Custom Non Gmo Soy Lecithin Factories & Manufacturers Pricelist - Huge Roc,China Supply Custom Reasonable Price High Quality Products Cheap Price - Zhongyi Plastic Technology Co.Supply OEM Custom 6x6 Reinforcing Welded Wire Mesh Factories & Manufacturers Pricelist - 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,China Supply Custom Farm Fence Products Cheap Price - 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 Cheap OEM/ODM Calcium Propionate Manufacturing Process Suppliers & Manufacturers Quotes - Huge Roc,Wholesale Cheap OEM/ODM Whitening Gel Mask Factory & Supplier Price - XingzhichenSymptomatic patients with C2 to C6 diseases are indicated for management,Wholesale Cheap OEM/ODM Brown Rice Protein Powder Products Cheap Price - Huge Roc, superficial thrombophlebitis, and bleeding.

Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.China Supply Custom Natural Dietary Fiber Factories & Manufacturers Pricelist - 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,m.hhomedecor.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 Die Casting Auto Parts Suppliers & Manufacturers Quotes - Highpoint Machinery, and early surgery in uncomplicated veins will not prevent the development of future varicosities.

Supply OEM Custom Grocery Shelves Factory & Supplier Price - INNOVATIVE, such as acute DVT,Supply OEM Custom Medical Face Mask Factory & Supplier Price - Xingzhichenpregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,Wholesale CE High Quality Artificial Palm Trees Products Cheap Price - Green Link New Materials Co., Ltd.,Wholesale Cheap OEM/ODM Artemisinin 99% Factory & Supplier Price - KeMing Medicines,Wholesale CE High Quality PU dressing Suppliers & Manufacturers Quotes - Xingzhichen—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 Grocery Store Shelving For Sale Products Cheap 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 Transdermal Stickers Factory & Supplier Price - XingzhichenIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (Wholesale CE High Quality Aluminum Die Casting Mold Factories & Manufacturers Pricelist - Highpoint Machinery). And massive bleeding due to injury to femoral veins,Wholesale CE High Quality Organic Protein Shake 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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Wholesale Cheap OEM/ODM First Aid Wound Dressing Suppliers & Manufacturers Quotes - Xingzhichen; these belong to the category of minimally invasive catheter-based procedures.Wholesale CE High Quality Breast Sticker Cup Injection Molding Machine Factories & Manufacturers Pricelist - FOD Electrical EngineeringIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.Wholesale CE High Quality Phone Case For Iphone 6 Factories & Manufacturers Pricelist - Shenzhen Hxs Technology. Alternatively,Supply OEM Custom Organic Pea Protein Powder Bulk Suppliers & Manufacturers Quotes - Huge Roc.Wholesale Cheap OEM/ODM Where Can I Get Baking Soda Suppliers & Manufacturers Quotes - Huge Roc.Supply OEM Custom High Temp Resistant Teflon Wire Suppliers & Manufacturers Quotes - FOD Electrical Engineering

Wholesale CE High Quality Fiberglass Aqua Slide For Pool Suppliers & Manufacturers Quotes - Shanghai Mutong Toys, 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.Supply OEM Custom Where Can You Buy Rice Protein Powder Factory & Supplier Price - Huge Roc,China Supply Custom Blower Wheel Aluminum Casting Factories & Manufacturers Pricelist - Highpoint Machinery,Plug SocketSupply OEM Custom Single-Row Crossover Rolling Type Suppliers & Manufacturers Quotes - Fenghe, recurrence rates,Wholesale CE High Quality Welded Wire Mesh Roll Factory & Supplier Price - Bluekin Industries Limited.Wholesale CE High Quality Duckback Hot Water Bag Factory & Supplier Price - Jade Rabbit Electrical Appliance,Wholesale Cheap OEM/ODM Baking Soda In Water Products Cheap 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 Cheap OEM/ODM Calcium Propionate Price For Food Beverage Factory & Supplier Price - Huge RocChina Supply Custom Die Casting Process Factory & Supplier Price - Highpoint Machinery;Wholesale CE High Quality Logistic Plastic Crate With Lid Suppliers & Manufacturers Quotes - 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.China Supply Custom Baling Steel Strapping Factories & Manufacturers Pricelist - Bluekin Industries Limited,Wholesale Cheap OEM/ODM High Unit Vitamin B Products Cheap Price - KeMing Medicines

Radiofrequency ablation

China Supply Custom Organic Whey Protein Powder Factory & Supplier Price - 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 Watercolor Painting Set 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.Wholesale Cheap OEM/ODM Diabetic Foot Dressing Suppliers & Manufacturers Quotes - Xingzhichen,Supply OEM Custom Hand Car Wash Equipment Suppliers & Manufacturers Quotes - Mingou,Ltd.

Foam sclerotherapy

Wholesale CE High Quality Brown Rice Protein Factory & Supplier Price - Huge Roc; it can be undertaken in the outpatient clinic,Supply OEM Custom What Is Whey Protein Factories & Manufacturers Pricelist - Huge Roc.China Supply Custom Eagle Wire Shelving Factories & Manufacturers Pricelist - INNOVATIVEObservational studies found that success rates vary from 82% to 100%,Supply OEM Custom Ammonium Bicarbonate Msds Suppliers & Manufacturers Quotes - Huge RocWholesale Cheap OEM/ODM Plastic Palette Factory & Supplier Price - Unionrise I&E. 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 (China Supply Custom Hard Drawn Wire Factories & Manufacturers Pricelist - Bluekin Industries Limited). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Wholesale CE High Quality Pea Protein Food Ingredients 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.China Supply Custom Ammonium Bicarbonate Vegan Suppliers & Manufacturers Quotes - Huge Roc,Rohs Heat Pump

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Supply OEM Custom Gear Products Cheap Price - Fenghe. 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 Artificial Plants And Trees Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd.,Wholesale CE High Quality Trenchless Machinery Suppliers & Manufacturers Quotes - Fenghe.China Supply Custom Protein Shake Recipes Factory & Supplier Price - Huge RocWholesale Cheap OEM/ODM Vitamin B12 Lozenge Suppliers & Manufacturers Quotes - KeMing Medicines.Wholesale CE High Quality Eye Mask Sleep Factory & Supplier Price - Xingzhichen.Supply OEM Custom ODM Mobile Phone Case Factory & Supplier Price - Shenzhen Hxs Technology.Wholesale Cheap OEM/ODM Lcd Nail Lamp Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY.Wholesale CE High Quality Daily Dietary Fiber Factory & Supplier Price - Huge Roc. External valvuloplasty, such as external vein valve wrapping,Wholesale CE High Quality Artificial Palm Tree Leaves Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd..Supply OEM Custom Diy Roller Foam Paint Brush Factory & Supplier Price - Unionrise I&EIt aims to increase the coating surface and restore valve competency by external supportWholesale Cheap OEM/ODM Razor Wire For Sale Suppliers & Manufacturers Quotes - Bluekin Industries Limitedand has not gained large popularity due to its efficacy. However,Wholesale Cheap OEM/ODM Electronic Hair Straightener Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY.Supply OEM Custom Mini Electronic Nail Dryer Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY

Overall, all management modalities appear to be safe and effective in the short term and midterm,Garment Alarm InktagsWholesale Cheap OEM/ODM Pea Plant Protein Powder Factories & Manufacturers Pricelist - Huge Roc.Wholesale CE High Quality Plastic Collapsible Crates For Plates Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd.;China Supply Custom selfadhesive wound dressing Factories & Manufacturers Pricelist - Xingzhichen. FS was associated with the highest failure rate.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 EngineeringHowever, high-Wholesale Cheap OEM/ODM Barbed Wire3.0 Factory & Supplier Price - Bluekin Industries Limited-term follow-China Supply Custom Gmo Free Soya Lecithin Factory & Supplier Price - Huge Roc.

Acknowledgments

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

References

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