What are the causes and treatments of varicose veins in the lower extremities?

  Simple superficial varicose veins of lower extremities, that is, superficial venous valve insufficiency of lower extremities, the scope of the lesion is limited to superficial veins of lower extremities, divided into primary and secondary, primary that is, no obvious triggering factors, congenital weakness of the venous wall, reduced elasticity and poor venous valve structure is the main cause of the onset of genetic; secondary triggering factors are heavy physical labor, prolonged standing, injury and cold, history of phlebitis, female pregnancy The secondary predisposing factors are heavy physical labor, prolonged standing, injury, cold, history of phlebitis, female pregnancy, and other causes of increased abdominal pressure. Because of the venous blood reflux in the lower extremities due to valve insufficiency, the venous pressure in the lower extremities increases, and because the superficial veins are located in the superficial subcutaneous layer and lack of muscle and connective tissue protection around them, the venous hypertension can cause the veins to grow and thicken over time, and varicose veins appear. In the early stage of the disease, there is no obvious discomfort, but with the gradual aggravation of superficial varicose veins, there is a feeling of soreness and heaviness in the lower limbs, and in the longer course of the disease, there can be skin nutritional changes, including skin pigmentation, eczema or ulcers, and pain can occur with superficial phlebitis.  Early mild to moderate varicose veins in the lower extremities can be maintained for a long period of time without development, which can be more than 30 years, with reasonable changes in lifestyle habits and appropriate conservative treatment. The measures taken are to reduce the long-term standing and long-term sitting posture, to elevate the lower limbs appropriately when lying down or sitting down, to carry out walking exercises appropriately to increase the role of calf muscle pump; to wear medical decompression stockings when standing or sitting for a long time to help lower limb venous reflux, to avoid injury and cold to the affected limbs, and to use drugs to promote venous reflux appropriately. Only those who have severe simple varicose veins in the lower limbs with corresponding complications should be considered for surgery, such as severe tortuous veins in the inner thighs after long-term development; long years of varicose veins, resulting in soreness or heaviness in the lower limbs after long time walking, which affects the quality of life; varicose veins often bleed and it is not easy to stop bleeding and healing; varicose veins cause changes in the skin properties of the lower limbs, such as eczema, bruising, ulcers, etc. The varicose veins cause changes in the skin properties of the lower limbs, such as eczema, bruising dermatitis, ulcers, etc., which are still ineffective after active conservative treatment.  Currently, the following surgical methods are commonly used: 1. traditional high ligation combined with trunk stripping of large and small saphenous veins, stripping of varicose vein masses and ligation of traffic branches 2. high ligation combined with endovenous laser electrocoagulation stripping of varicose vein masses and ligation of traffic branches 3. high ligation trunk stripping combined with transilluminated direct vision spinotomy 4. transilluminated direct vision spinotomy combined with laser or radiofrequency ablation. There is no single method that can treat varicose veins perfectly, and any surgical method has a certain recurrence rate. It is important to emphasize that most patients with varicose veins also have deep vein valve insufficiency in the lower extremities and often have edema in the lower extremities in addition to superficial varicose veins, which makes them unsuitable for superficial varicose vein surgery and requires deep vein valve repair at the same time.