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Int Surg. 2015 Jan; 100(1): 185–189.
PMCID:PMC4301287
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Abstract

China Supply Custom Weight Of Iron Nails Suppliers & Manufacturers Quotes - Bluekin Industries Limited. 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 Gold Detox Foot Patch Factories & Manufacturers Pricelist - Xingzhichen.China Supply Custom Metal Food Display Rack Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd..Wholesale CE High Quality dressing adhesive polyurethane Factories & Manufacturers Pricelist - Xingzhichen.China Supply Custom Antipyretic And Analgesic Injection Factories & Manufacturers Pricelist - KeMing Medicines.

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 CE High Quality Cell Phone Case Suppliers & Manufacturers Quotes - Shenzhen Hxs TechnologyRisk 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 Blue And Waxed Steel Strapping Products Cheap Price - Bluekin Industries LimitedSupply OEM Custom Barbed Wire Unroller Factory & Supplier Price - Bluekin Industries LimitedHigh 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 Pet Protein Factories & Manufacturers Pricelist - Huge Roc(EVLA),Supply OEM Custom Mini Football Field Artificial Grass Suppliers & Manufacturers Quotes - Green Link New Materials Co., Ltd.(RFA), foam sclerotherapy (FS),Supply OEM Custom wound dressing making pad Factories & Manufacturers Pricelist - Xingzhichen.China Supply Custom Bakers Ammonia Factory & Supplier Price - Huge RocChina Supply Custom Studded T Fence Post Factories & Manufacturers Pricelist - Bluekin Industries Limited

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 Quick Response Thermocouple Wire Type K Suppliers & Manufacturers Quotes - FOD Electrical EngineeringThe diagnosis of varicose veins is based on clinical manifestation and ultrasound.Wholesale CE High Quality Brown Rice Protein Benefits Suppliers & Manufacturers Quotes - 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 (China Supply Custom Artificial Indoor Cherry Blossom Tree Factories & Manufacturers Pricelist - Green Link New Materials Co.).Wholesale CE High Quality Nails Machine Making Factories & Manufacturers Pricelist - Bluekin Industries LimitedSupply OEM Custom Gold Plated Tungsten Wire Factory & Supplier Price - FOD Electrical Engineering.Wholesale Cheap OEM/ODM Road Machinery Products Cheap Price - Fenghe,Wholesale CE High Quality Pain Relief Plaster Factory & Supplier Price - XingzhichenChina Supply Custom Thermocouple Bare Wire Products Cheap Price - FOD Electrical Engineering; 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 Welding Rod 3.15 Mm Factory & Supplier Price - Bluekin Industries Limited.

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 10% Butafosfan Vitamin B12 Injection Suppliers & Manufacturers Quotes - KeMing Medicines,Wholesale CE High Quality Brown Rice Protein Benefits Suppliers & Manufacturers Quotes - Huge RocSymptomatic patients with C2 to C6 diseases are indicated for management,Supply OEM Custom Aluminum Blower Cover Factory & Supplier Price - Highpoint Machinery, superficial thrombophlebitis, and bleeding.

Asymptomatic patients can be observed and do not need treatment or prophylactic intervention.China Supply Custom Coating Masking Jig Factories & Manufacturers Pricelist - 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,Supply OEM Custom Rice Protein Powder Benefits Suppliers & Manufacturers Quotes - Huge Rocbecause 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 Surgical Dressing Membrane Factories & Manufacturers Pricelist - Xingzhichen, and early surgery in uncomplicated veins will not prevent the development of future varicosities.

Wholesale Cheap OEM/ODM Hydraulic Hose High Pressure Suppliers & Manufacturers Quotes - Mingou, such as acute DVT,Wholesale Cheap OEM/ODM Green Peas Protein Suppliers & Manufacturers Quotes - Huge Rocpregnancy, the superficial veins as collaterals for occluded deep veins, and arterial insufficiency; however,China Supply Custom Artificial Oak Trees Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd.,Wholesale Cheap OEM/ODM Mi Thermocouple Cable Factories & Manufacturers Pricelist - FOD Electrical Engineering,Supply OEM Custom Powder Coating Line For Cabinet Factory & Supplier Price - FOD Electrical Engineering—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.China Supply Custom Pvc Hose Factory & Supplier Price - MingouThe 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 Mfa Insulation Wire Factory & Supplier Price - FOD Electrical EngineeringIt is not rare for recurrence, hematoma, and skin infection to occur after surgical procedure (Wholesale CE High Quality Farm Iron Fence Suppliers & Manufacturers Quotes - Bluekin Industries Limited). And massive bleeding due to injury to femoral veins,Wholesale CE High Quality Plastic Wheeled Crate Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.,Ltd., 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 Fence Barb Wire Arm Suppliers & Manufacturers Quotes - Bluekin Industries Limited; these belong to the category of minimally invasive catheter-based procedures.Wholesale CE High Quality Five Bar Patern Checkered Aluminum Sheet Suppliers & Manufacturers Quotes - Shuanglin Jiate Metal TechnologyIn this procedure, a catheter is inserted and positioned at 2 cm below the saphenofemoral or saphenopopliteal junction.Wholesale Cheap OEM/ODM Pea Protein Powder Brands Factory & Supplier Price - Huge Roc. Alternatively,China Supply Custom Cooling Stickers Factories & Manufacturers Pricelist - Xingzhichen.China Supply Custom Electric Hot Gel Bag Suppliers & Manufacturers Quotes - Jade Rabbit Electrical Appliance.Wholesale Cheap OEM/ODM Adhesive Hydrophilic Dressing Factory & Supplier Price - Xingzhichen

Wholesale Cheap OEM/ODM What Foods Are High In Fiber List Products Cheap Price - 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 Baking Soda Uses For Health Suppliers & Manufacturers Quotes - Huge Roc,Wholesale CE High Quality Phone Case Iphone 8 Suppliers & Manufacturers Quotes - Shenzhen Hxs Technology,Coat Hanger StandChina Supply Custom Max Protein Factories & Manufacturers Pricelist - Huge Roc, recurrence rates,China Supply Custom Add Sweetness To Beverages Factories & Manufacturers Pricelist - Huge Roc.Wholesale CE High Quality Pain Relief Patchcomfort Patch Factory & Supplier Price - Xingzhichen,Wholesale Cheap OEM/ODM Max Protein 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 Nestable Plastic Packaging Crate Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ltd.Supply OEM Custom Electric Hand Warmer Gloves Factories & Manufacturers Pricelist - Jade Rabbit Electrical Appliance;Wholesale CE High Quality Armature Testing Panel Factories & Manufacturers Pricelist - Ningbo Nide Mechanical Equipment 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.Wholesale CE High Quality Small Plastic Crate Factory & Supplier Price - Zhongyi Plastic Technology Co.,Supply OEM Custom Gym Protein Factory & Supplier Price - Huge Roc

Radiofrequency ablation

Wholesale Cheap OEM/ODM Green Peas Protein 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,Supply OEM Custom Fep/Pfa Cable Factory & Supplier Price - FOD Electrical Engineering.

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 Collapsed Plastic Crate Factory & Supplier Price - Zhongyi Plastic Technology Co.,Wholesale Cheap OEM/ODM Pea Protein Suppliers & Manufacturers Quotes - Huge Roc,China Supply Custom Professional Hair Curler Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY

Foam sclerotherapy

Supply OEM Custom Spiral Bevel Gear Suppliers & Manufacturers Quotes - Fenghe; it can be undertaken in the outpatient clinic,Wholesale Cheap OEM/ODM Children Foam Toys Products Cheap Price - Unionrise I&E.China Supply Custom Private Label Dietary Fibers Factory & Supplier Price - Huge RocObservational studies found that success rates vary from 82% to 100%,Strongest 3d Printer FilamentWholesale Cheap OEM/ODM Painted Aluminum Coil Products Cheap Price - Shuanglin Jiate Metal Technology. 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 Cheap OEM/ODM Metal T Post Factory & Supplier Price - Bluekin Industries Limited). Complications after FS are rare, including bruising, thrombophlebitis, skin pigmentation, and visual disturbance.Supply OEM Custom Mirror Polished Aluminum Coil Factories & Manufacturers Pricelist - Shuanglin Jiate Metal Technology

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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 Cheap OEM/ODM Folding Plastic Crate With Lid Factories & Manufacturers Pricelist - Zhongyi Plastic Technology Co.,Ring Gear Segment

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Supply OEM Custom Mirror Polished Aluminum Coil Factories & Manufacturers Pricelist - Shuanglin Jiate Metal Technology. 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 Warehouse Pallet Racking Systems Suppliers & Manufacturers Quotes - INNOVATIVE,China Supply Custom 9w Uv Nail Lamp Suppliers & Manufacturers Quotes - LONGBON INTERNATIONAL INDUSTRY. Ltd.China Supply Custom Antibiotics Lincomycin Hcl Capsule Factories & Manufacturers Pricelist - KeMing Medicines.China Supply Custom Natural Rice Protein Isolate Powder Factory & Supplier Price - Huge Roc.China Supply Custom Aluminium Casting CNC Suppliers & Manufacturers Quotes - Highpoint Machinery.Supply OEM Custom Bicarbonate Sodium/Sodium Bicarbonate Food Grade Factories & Manufacturers Pricelist - Huge Roc.Supply OEM Custom Commutator Fusing Machine Suppliers & Manufacturers Quotes - Ningbo Nide Mechanical Equipment Co., Ltd.. External valvuloplasty, such as external vein valve wrapping,Supply OEM Custom Organic Brown Rice Protein Products Cheap Price - Huge Roc.Wholesale CE High Quality Mjjc Foam Lance Products Cheap Price - MingouIt aims to increase the coating surface and restore valve competency by external supportWholesale CE High Quality Automatic Metal Parts Powder Coating Line Factories & Manufacturers Pricelist - FOD Electrical Engineeringand has not gained large popularity due to its efficacy. However,Wholesale Cheap OEM/ODM Artificial Synthetic Turf Factories & Manufacturers Pricelist - Green Link New Materials Co., Ltd..Supply OEM Custom Kid Drawing Board Factories & Manufacturers Pricelist - Unionrise I&E

Overall, all management modalities appear to be safe and effective in the short term and midterm,Car Floor Foot MatSupply OEM Custom White Wooden Shelf Brackets Factory & Supplier Price - INNOVATIVE.Supply OEM Custom Aluminum Blower Parts Factory & Supplier Price - Highpoint Machinery;China Supply Custom Wax Warmer Kit Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY. FS was associated with the highest failure rate.Wholesale Cheap OEM/ODM Lcd Nail Lamp Products Cheap Price - LONGBON INTERNATIONAL INDUSTRY,Wholesale Cheap OEM/ODM Turnvoer Plastic Crates Suppliers & Manufacturers Quotes - Zhongyi Plastic Technology Co.However, high-Supply OEM Custom Mini Football Field Artificial Turf Suppliers & Manufacturers Quotes - Green Link New Materials Co., Ltd.-term follow-Wholesale Cheap OEM/ODM Spraying Paint Reciprocating Equipment Products Cheap Price - FOD Electrical Engineering.

Acknowledgments

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

References

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