Varicose veins in the lower extremities are a common vascular disease, with an incidence of up to 30% and mostly seen in middle-aged and elderly people, mainly manifested as: tortuous and dilated leg veins, bulging in the shape of earthworms and lumps, which may only have cosmetic changes in the early stage, but various symptoms will appear in the late stage, such as: soreness and edema in the lower legs, melanosis in the skin, chronic eczema and itching, rupture and bleeding of varicose veins, and even ulcers in the lower extremities that do not heal for a long time (commonly known as “old rotten legs”). High venous pressure in the lower limbs is the root cause of varicose veins in the lower limbs. As humans evolved from reptiles to walk upright, the height of the heart from the ground increased and blood from the lower extremities had to overcome gravity to return to the heart to complete blood circulation. The veins of the lower extremities are the conduits for the return flow of blood, and there are many “one-way switches (venous valves)” inside to ensure that blood can only flow in the direction of the heart and not in the opposite direction to the foot. Long-term venous hypertension destroys the “one-way switch”, blood reflux occurs, and the straight vein delivery pipe is bent and deformed due to the huge pressure, resulting in varicose veins. It is only a matter of time before varicose veins eventually produce complications that can seriously affect the quality of life. Varicose veins are produced by increased venous pressure in the lower extremities, and varicose veins cause poor blood flow back to the lower extremities, which in turn increases venous hypertension, and this vicious cycle eventually causes skin nutrient disorders, resulting in itching, eczema, and skin ulcers. Often people think “people around me have more varicose veins than I do, they are all bulging, and I don’t see anything wrong with them”. In fact, most people see the disease at a point in time, but not the final outcome. After varicose veins in the lower extremities, the veins do not return well and the blood leaks out into the tissue spaces making the skin dark. Metabolic waste accumulates in the lower extremities for a long time, resulting in nutritional disorders of the skin, producing eczema and chronic ulcers that do not heal over time. The prevention and care of varicose veins is especially important for people such as teachers, salesmen, traffic police, and health care workers because they are prone to varicose veins in their middle and old age due to prolonged standing. Everything that helps to reduce the pressure in the veins of the lower limbs can prevent the occurrence of varicose veins in the lower limbs. Sitting or standing for a long time makes the blood in the lower extremities unable to flow, and walking or flexing and extending the ankle joint makes the calf muscles contract, and the calf muscles become the “second heart” of the human body, and contract like a huge pressure pump to squeeze the blood from the lower extremities back to the heart. Middle-aged and old people should avoid sitting or standing for a long time and move their lower limbs properly for a certain period of time to promote blood return. Patients with early manifestations of varicose veins try to elevate the lower limbs at rest and can also wear sequential decompression compression stockings to promote blood return and reduce the pressure in the veins of the lower limbs to slow down the development of varicose veins. Normal venous valves, preventing blood backflow damage to the venous valves, blood backflow, producing varicose veins lower limb varicose veins have a very high incidence, it is important to choose a reasonable and effective treatment plan. The tortuous veins prevent blood from flowing back to the lower extremities, and effective treatment should allow blood to flow back to the lower extremities and solve the dilemma of blood stagnation. There are no medications that can straighten the varicose veins and treat the root cause of varicose veins in the lower extremities. Effective treatments achieve the goal of improving circulation in the lower extremities by diverting blood to the deeper, larger veins, and with this in mind, the more minimally invasive the treatment option, the more easily accepted by the public. Based on the clinical experience of our department, we feel that the following minimally invasive treatment options are worth adopting: (1) Sclerotherapy: For patients with mild itching and soreness of the skin caused by varicose veins in the lower extremities, but whose varicose veins affect the aesthetic appearance. Our department adopts polyglactin foam sclerotherapy to inject varicose veins.
The varicose vein is injected, and the endothelium of the vein is damaged and the connective tissue proliferates, causing fibrosis and occlusion of the dilated official cavity. It is easy to operate, inexpensive, and can be done at home or at work after the procedure, especially for women who love beauty. (2) High saphenous vein ligation + endovenous laser treatment: It can effectively reduce the recurrence of disease after surgery, improve the symptoms of skin itching and soreness, and promote the healing of skin ulcers. And the operation is less traumatic, with fewer complications, and you can get out of bed by yourself on the second day after the operation. Our department uses an imported laser generator to perform intravenous laser closure, and the efficacy of the procedure is confirmed and highly appreciated by the patients.