KT syndrome is a congenital vascular developmental anomaly called Klippel-Trenaunay syndrome, also known as “congenital venous malformation bone hypertrophy syndrome”, with the triad of wine colored nevus, superficial varicose veins and limb hypertrophy as the main manifestations. KT syndrome can be easily diagnosed through examination and examination by the doctor, but what kind of KTS needs surgical treatment? More than 85% of clinical cases are venous type and only about 10% are arterial type. In infancy and early childhood, venous KTS generally does not require surgery, while arterial KTS can significantly affect limb development and requires early surgery. ① venous type – mainly venous abnormalities, including superficial varicose veins, venous aneurysms, deep venous valve insufficiency, deep venous defects, etc.; ② arterial type and mixed type – i.e., arteriovenous fistula type mainly based on the abnormal arteriovenous fistula of the affected limb; including arterial blockage The arterial type and the mixed type belong to PW syndrome, because of the similar clinical manifestations, they belong to the same vascular malformation, but the treatment principles are different. 1.Surgical treatment of venous type Superficial varicose vein lesion alone, especially for deep vein patency, swelling and heaviness of lower limbs and severe pain symptoms, recurrent thrombosis and ulcer patients, minimally invasive superficial vein surgery is feasible, usually with local varicose superficial vein stripping or minimally invasive ablation therapy, which can effectively relieve symptoms and improve appearance. Deep venous defects or occlusions are not amenable to this type of surgery. Generally, around puberty, patients with uncontrolled venous type will develop superficial varicose veins with tortuous dilated venous masses on the surface, which will affect the appearance on the one hand, and may lead to complications such as thrombosis and ulceration on the other hand, and surgical treatment can be considered at this time. 2, arterial type intervention KT syndrome often causes the affected limb longer than the healthy limb, resulting in one leg longer and one leg shorter, whether surgery is needed depends on whether there is an arteriovenous fistula or arterial lesion, and an MRI of the lower limb vasculature can be done if possible. If it is arterial KT syndrome, surgical treatment is needed to embolize some abnormal arteries. Muscle soft tissue and bone hypertrophy can be treated with embolization to limit the development of the affected limb and reduce claudication. Transcatheter arterial interventional embolization has become the mainstay of treatment for arteriovenous fistulas, which is performed by embolization with pinyamycin + ultra-liquefied iodine oil with a microcoil embolization. The principle of treatment is “resection of the lesion and restriction of the flow”, that is, if the lesion can be resected, the fistula is blocked from the arterial side to increase the distal blood flow, and the return vein is increased to alleviate the disease and slow its progression. Smaller arteriovenous fistulas above the knee are treated with microspring coils or sclerotherapy, and arteriovenous fistulas at the knee are treated with looped artificial vascular replacement. This treatment is often done in the cosmetic laser clinic of the dermatology department, and can be done with a transdermal Nd:YAG laser or a large lesion with a depth of 10 mm subcutaneous intracavitary Nd:YAG laser. Large areas of wine discoloration on the extremities are treated with a combination of pulsed fuel laser and percutaneous Nd:YAG laser with ice cooling, and carbon dioxide laser when combined with hyperkeratosis of the skin. Erythema on the face, head and neck can be treated with laser or photodynamic therapy, while the extremities are generally not recommended for such treatment because it is difficult to completely eliminate the lesions without removing the basis of vascular malformation. 4.How to treat KTS without surgery? Mild limb growth and thickening, superficial varicose veins as the main symptoms, you can wear medical secondary compression elastic stockings, the kind that needs to be tailored to promote blood return, thus improving the difference between the legs, can control varicose veins, reduce the heaviness and swelling of the lower limbs caused by venous stasis, and prevent the occurrence of thrombotic superficial phlebitis. The price of imported medical compression stockings is about 600 yuan. Adult compression stockings are available in a wide range of models, with secondary and tertiary compression. For children, especially young children’s elastic stockings are relatively few, there are some imported elastic stockings need to customize children’s elastic stockings abroad, the price is relatively expensive, are more than a thousand dollars. At present, Taiwan Medeco brand has launched the world’s first children’s compression stockings, which are available from a few months to adolescence, with a price of about five to six hundred, which greatly facilitates the pressure treatment needs of children with KTS.