Simple superficial varicose veins of lower extremities refer to those whose lesions are limited to superficial veins of lower extremities, whose lesions include saphenous vein, small saphenous vein and its branches, and the majority of patients occur in saphenous vein, which is clinically diagnosed as saphenous varicose vein. So, what are the common problems of varicose veins in lower limbs? The following are the common problems of varicose veins in the lower extremities.
1.Do all saphenous varicose veins have to be treated surgically?
Not necessarily. Patients and doctors consult and discuss and need to decide whether to treat surgically or not according to the situation. Patients need to consult with an experienced physician and then choose the option that is right for them based on their situation. In some cases, the treatment is requested because of aesthetics and the desire to wear dresses, especially in the case of wonderful women, and minimally invasive incision-free methods such as innovative minimally invasive methods, laser methods, etc. are recommended.
Varicose veins are a slowly developing disease and proper treatment will benefit the patient; if the patient has a combination of significant deep venous reflux, ulcers or congenital arteriovenous malformations, the surgical results will be less effective.
2.What are the consequences if my varicose veins are not treated? Why does skin darkening occur?
We know that flowing water does not rot and a household pivot does not become worm-eaten. If varicose occurs in the superficial veins of the lower limbs, that is, the saphenous vein, it means that the superficial veins of the lower limbs are bent, the blood flow is not smooth, and the metabolic products of the lower limbs, including toxic substances, cannot be eliminated in time, therefore, the nutrients of the skin are reduced; if the varicose veins are not treated and cleared, many complications will occur after a long time, such as eczema, itching, skin color change of the ankle, such as purple, gray and black, skin ulcers and ankle edema, etc., which are serious. And ankle edema, etc. In serious cases, superficial thrombophlebitis will occur, and in a few cases, deep vein thrombosis will inevitably occur, and the thrombus will be dislodged and enter the pulmonary artery along the blood flow, and pulmonary embolism will occur, which is life-threatening.
3.Surgery removed my varicose veins, how will my blood flow after the surgery?
There are two systems of superficial veins and deep veins in human lower limbs. After surgery to remove the superficial varicose veins with lesions, the blood of lower limbs will flow from the deep veins and other normal superficial veins under the skin, and there will be no adverse reactions, on the contrary, the surgery will avoid the above adverse consequences, which is beneficial to patients.
4.Is there any drug that can cure varicose veins?
There is no drug that can cure varicose veins, but a few drugs have the effect of relieving symptoms (discomfort, pain or swelling), and even if they are effective, their therapeutic effect may be equivalent to that of medical compression stockings. Some Chinese medicines, ointments and potions lack serious supervision and identification by the real department and have little or no therapeutic effect, but may bring side effects. Japanese natto is not effective for varicose veins.
5.Can surgery cure varicose veins radically and without recurrence?
Varicose veins are a chronic disease, unlike tumors and acute heart disease, which have serious life-threatening effects, but without treatment, most of them will only continue to deteriorate and will not heal on their own. Surgery is a complete treatment for varicose veins, but a few patients will inevitably have post-operative complications, such as post-operative recurrence and the need for re-operation if recurrence is severe. Any surgical procedure for varicose veins has the possibility of recurrence, but the rate of recurrence varies.
According to the current observation, there is no recurrence within 3 years with the minimally invasive method I use for patients.
6.What do I need to pay attention to before and after the surgery?
At present, most of the doctors in China do not perform saphenous vein surgery on an outpatient basis, but require patients to be hospitalized; in order to reduce patients’ pain, most hospitals in China perform the surgery under intravenous anesthesia or general anesthesia.
The diagnosis of saphenous vein can be made by clinical examination, and ultrasound is required before surgery; in special cases, such as complicated cases, deep venography is required, which is an invasive examination.
In the morning before the operation, no food and no water will be consumed. If women catch their menstrual period, they should inform the doctor in advance and try to avoid the operation during their menstrual period.
You can drink a small amount of water first 4 hours after the surgery, if there is no choking cough, you can gradually drink more water, drink fluids on the night of the surgery, avoid large fish and meat to avoid indigestion and bloating, and resume normal diet on the 2nd day.
Activity issues.
If not sleepy after surgery, we encourage patients to get out of bed early and walk slightly, which is beneficial to avoid lower limb thrombosis, early recovery and reduction of complications.
Wound pain and bloody exudate.
7.Can the usual socks be worn instead of medical elastic stockings? What is the role of medical elastic socks?
It is impossible to replace medical compression stockings with socks that you normally wear.
Medical compression stockings are made of spandex material, and the pressure is at least 15mmHg in the ankle, and the pressure decreases gradually upward, so the elasticity is long-lasting, which is useful for delaying the development of varicose veins, preventing venous thrombosis and edema in the ankle, but it will not cure the varicose veins. Patients who are afraid of surgery are recommended to wear medical compression stockings. The compression of the compression stocking for therapeutic purposes needs to be 25mmHg, and it is necessary to choose the right type of medical compression stocking according to the circumferential size of the ankle and calf.
It is suitable for patients who adopt non-surgical treatment, post-surgical patients; patients with swelling of lower limbs; patients with deep vein thrombosis or post-deep vein thrombosis syndrome of lower limbs.
8.How long should I wear elastic stockings after saphenous varicose vein surgery?
We suggest that after replacing the elastic stockings after surgery, initially wear them continuously during the day and night for 1 week, and then you can wear them during the day and take them off at night. It is required to wear compression stockings for 3 months after surgery. Some people hate wearing compression stockings, but they must be worn for at least 1 month.
9. What are the risks and benefits of taking warfarin? What are the signs of taking more drugs? How can I avoid brain bleeding?
When there is a deep vein thrombosis in the lower extremity, taking warfarin can prevent further development of the thrombosis. The amount of medication you take is extremely important. If you take less, it will be ineffective and the clot will develop further. If more is taken, there is a risk of internal bleeding, especially intracranial bleeding. Therefore, the doctor verbally advises or at the same time informs the patient in writing to draw blood for coagulation image after 5-10 days after taking the medication to observe the level of the international standard ratio of prothrombin time INR, ideally it is safer to keep the INR value between 2 and 3. Some patients take the drug for a long time and do not even go to the hospital to check the INR value, as a result, brain hemorrhage occurs and life-threatening or even death occurs. Some people are sensitive to the drug, or take other drugs at the same time, increasing the effect of warfarin. Remember: If you have bleeding gums or blood in your urine or other appearances, stop taking warfarin first, go to the hospital immediately to check the INR value and consult your doctor.
Do not smoke or drink alcohol while taking the medication. Since warfarin and many drugs have cross-reactivity, you need to inform your doctor of all the drugs you are currently taking. So that the doctor can guide the rational use of medication. There are different dosing regimens depending on the drug dose and the patient’s condition: regimen 1: 2 tablets on day 1, then 1 tablet daily; regimen 2: 3 tablets on day 1, 2 tablets on day 2, and 1 tablet daily from day 3 onwards. Take them at the same time every day fixed. Some patients need to take the medication for 6 months, and some for life.