1.What kind of disease is varicose veins in the lower extremities? What are its clinical manifestations?
Varicose veins of lower extremities are common diseases in vascular surgery, mainly manifesting as the tortuous expansion of superficial veins of lower extremities, and in serious cases, such as “earthworm-like” appearance, which can only have the change of appearance in the early stage, or the soreness and swelling of calves after standing for a long time, but in the late stage, various complications will appear, such as calf edema, skin pigmentation, sebaceous scleroderma, bruised dermatitis, chronic eczema, chronic ulcers that do not heal (commonly known as “old rotten feet”) and even bleeding from ruptured varicose veins.
2.Is this disease common? What is the incidence in our country?
Varicose veins in the lower extremities are very common, in Europe and America, about 25% of adult men and 15% of adult women suffer from varicose veins of different degrees, the incidence rate in our country is relatively low, but also above 10%, because the population base in China is very large, so the total number of patients is much higher than that in Europe and America.
3.Why we don’t see so many patients in general?
Because varicose vein patients will not easily let people see their ugly legs full of “veins”, they tend to wear pants all year round, for women friends, having this disease means losing the opportunity to wear beautiful dresses forever, and losing a confidence in life.
4.How do varicose veins in lower limbs occur?
There are two factors in the formation of varicose veins in the lower limbs, the first is the cause of the blood vessels themselves, this factor is often brought by congenital genetics, that is to say, their blood vessels are weaker than others at birth and prone to varicose, so it is said that varicose veins have a genetic tendency. Next is the acquired reason, any factors that increase the pressure on the veins of lower limbs may contribute to the occurrence of varicose veins, such as heavy physical labor, long standing work, pregnancy, etc. Therefore, varicose veins of lower limbs are also related to each person’s occupation. Farmers, pickers, bus conductors, teachers, surgeons, etc. are the people with high incidence of varicose veins in lower limbs.
5.What are the dangers of varicose veins in lower limbs?
The varicose veins of lower limbs can occur in the late stage, and the skin of lower leg boot area can be ulcerated for a long time, and the huge ulcer needs skin implant surgery, and the long-term chronic ulcer can become cancerous, and even need amputation. Once the varicose vein ruptures, it can lead to hemorrhage and even life-threatening.
6.Is it better to treat varicose veins in the lower limbs as early as possible?
The more advanced varicose veins in the lower extremities, the more serious the disease is, and the treatment is quite tricky, the effect is also poor, and the recurrence rate is high, any disease is important in early treatment, and saphenous varicose veins are no exception.
7.What treatments are available for varicose veins in the lower extremities?
The traditional treatment method for varicose veins in the lower limbs is saphenous vein aspiration, which requires multiple incisions on the skin of the lower limbs to extract the saphenous vein one by one with an aspirator, and the pain is obvious after the operation, and many patients are afraid to walk on the ground for two or three days because of the pain after the operation. The scar was very unsightly. In the last decade, various minimally invasive methods of varicose vein treatment have emerged, such as laser endovenous closure, radiofrequency endovenous closure, TRIVEX shaving method, punctiform suction and foam sclerotherapy, etc. The most representative one is laser endovenous closure, but these techniques are still limited to a few large hospitals, and most other hospitals are still using traditional surgical methods.
8.What is the principle of laser treatment for varicose veins in lower limbs? What are its advantages?
The principle of laser treatment for varicose veins is very simple: the saphenous vein is punctured through an interventional method, a catheter is inserted, a laser fiber is introduced, the endothelium of the vein is destroyed by laser heat, and then the vein is closed and fibroticized by compression with a postoperative elastic bandage or elastic stocking, which is eventually absorbed by the body and disappears. Its main advantages include small incision (1-3mm incision), no scars after surgery, short hospital stay, even outpatient treatment, little pain and no interruption of work and life.
9.Is laser treatment of varicose veins a mature technology? Is it dangerous?
Laser treatment of varicose veins has a history of nearly a decade and is quite mature, as it can close some of the thinner varicose veins in the lower leg, which is not possible with traditional phlebotomy. Laser treatment of varicose veins is a very safe treatment method, the main danger is mainly skin burns, but the incidence is very low, I have done more than a hundred cases of laser surgery in the past, and not a single case of skin burns occurred.
10.Does laser treatment of varicose veins recur?
There is a certain recurrence rate of any treatment for varicose veins in the lower extremities, which often occurs in those patients with severe disease, but as long as the laser treatment is performed early and the maintenance is insisted after the surgery, the recurrence rate is very low.
11.What is the most suitable season to receive treatment for varicose veins in the lower extremities?
There is a folk saying that the incision infection will occur when the surgery is done in hot weather, whether it is justified or not, because there is almost no incision in laser surgery, so there is no problem of incision infection, as long as the disease needs, no matter what season is suitable for treatment.
12.What are the preventive measures for varicose veins in lower limbs?
It is better for people who work in standing position to wear medical elastic stockings preventively, the pressure of elastic stockings can help lower limb vein return and reduce lower limb vein pressure, thus delaying the occurrence of varicose veins; avoid standing still, standing and sitting still for a long time, try to walk more, start the muscle group of calf to make venous blood return, if space does not allow, at least move the feet to facilitate circulation. When sleeping, you can pad your feet slightly to allow blood from the legs to flow to the body parts. Treatment can cause abdominal hypertension. Drink constipation, because increased abdominal pressure can block the venous return to the lower extremities and increase the severity of varicose veins in the lower extremities. Maintain a normal diet and avoid excessive obesity. Excessive weight will weaken the muscle-assisted strength, so the venous blood will accumulate in the lower limbs, prompting the occurrence of varicose veins.
13.There are many advertisements on TV and newspapers saying that there are some injection methods to treat varicose veins, are they credible?
The advantage of this method is that it does not require hospitalization and the treatment cost is low, but the disadvantage is that it cannot treat the main trunk of the saphenous vein, so its recurrence rate is high, and it also causes skin necrosis and deep vein thrombosis. The disadvantage is that it cannot treat the main stem of the saphenous vein, so its recurrence rate is high, and it also has complications such as skin necrosis and deep vein thrombosis. Currently in our country sclerotherapy is mostly confined to some outpatient clinics, treatment is often not vascular surgery specialist, treatment is not standardized, sclerosing agent is still very old sodium cod liver oil acid, poor results, high recurrence rate. Recently, the use of a foam sclerosing agent called Microfoam has greatly enhanced the efficacy of sclerosing agent injection, while the side effects are relatively reduced, and even the saphenous vein trunk can be treated under ultrasound guidance, so the recurrence rate is greatly reduced, which is a powerful supplement to laser or surgical treatment.
14.I had saphenous vein stripping surgery in our local hospital three months ago, and the skin of my ankle has been feeling “numb” after the surgery. Is it always going to be like this?
This is because the surgery damaged a skin nerve in the calf, this nerve is called saphenous nerve, which mainly governs the skin sensation in the inner part of the calf, and it goes with the saphenous vein in the calf. It takes six months to two years to recover depending on the extent of the injury. Nowadays, the development of minimally invasive laser surgery has greatly reduced the chance of saphenous nerve injury.
15.I am a varicose vein patient, the varicose veins in my lower leg bulge like earthworms, last time I accidentally touched a hard object on my lower leg, one of the varicose veins cut a small opening, and the blood flowed like water, I was so scared at that time, I didn’t know how to stop the bleeding, and a lot of blood came out, what should I do if I encounter similar situation in the future?
Venous rupture and bleeding is a common complication of varicose veins in the lower extremities, the most important thing is to stay calm and never panic when you encounter this situation, you can immediately press the bleeding blood vessel with your hand and then take a clean cloth to bandage it, after it stops bleeding, immediately send it to a nearby hospital with vascular surgery specialty for treatment, if there is no vascular surgery specialty locally, you can choose a larger general hospital for general surgery. If there is no local vascular surgery specialist, you can choose a larger general hospital for general surgery. So varicose veins should never be taken lightly, once bleeding, if not handled properly, such as some people faint when they see bleeding, it will definitely lead to massive bleeding and even life-threatening.