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Related Concept Videos

Varicose Veins II: Diagnostic Studies and Interprofessional Care01:26

Varicose Veins II: Diagnostic Studies and Interprofessional Care

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Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
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Venous Thrombosis III: Interprofessional Care01:29

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Varicose Veins I: Introduction01:26

Varicose Veins I: Introduction

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Varicose veins, or varicosities, are abnormally dilated and twisted superficial veins caused by venous valve incompetence. This condition commonly affects the lower extremities, especially the saphenous veins, due to the higher pressure from prolonged standing and walking. However, varicosities can also occur in other areas, such as the esophagus, vulva, spermatic cords, and anorectal region.Etiology and typesPrimary varicose veins, often idiopathic, are more common in women due to inherent...
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Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Venous Thrombosis IV: Nursing Management01:30

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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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Abalakov: Posterior mandibular anchorage technique for orthodontic treatment.

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Headache after septoplasty.

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Predictive Value of a Preoperative Test for the Reversibility of the Reflux After Phlebectomy with Preservation of the Great Saphenous Vein.

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Persistent incompetent truncal veins should not be treated immediately.

P Pittaluga1, S Chastanet2

  • 1Riviera Veine Institut, Monaco paulpittaluga@hotmail.com.

Phlebology
|March 3, 2015
PubMed
Summary

Treating only varicose veins, not all incompetent truncal veins, is safe and effective for chronic venous disorder. This approach preserves main veins and is suitable for many patients, making systematic truncal vein treatment unnecessary in most cases.

Keywords:
ASVALTruncal refluxVaricose veins

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Area of Science:

  • Vascular Surgery
  • Phlebology
  • Venous Disease Management

Background:

  • Traditional treatment for chronic venous disorder involves systematically addressing incompetent truncal veins.
  • This study evaluates outcomes of selectively treating varicose tributaries while preserving refluxing truncal veins.

Purpose of the Study:

  • To assess the efficacy and safety of phlebectomy focused on varicose tributaries without treating all incompetent truncal veins.
  • To determine if preserving the great saphenous vein (GSV) impacts clinical and hemodynamic outcomes.

Main Methods:

  • Retrospective analysis of ambulatory selective varices ablation under local anesthesia (ASVAL) procedures over four years.
  • Included 1212 lower limbs treated with single phlebectomy, preserving a refluxing GSV.
  • Clinical and hemodynamic outcomes assessed post-procedure and annually.

Main Results:

  • 1212 lower limbs in 816 patients (mean age 53.7) were analyzed, with 85.6% classified as CEAP C2.
  • Midterm follow-up (mean 44.5 months) showed a 5-year cumulative incidence of varicose recurrence at 13% and secondary major procedures at 4.5%.
  • GSV reflux extension and multiple calf tributary connections were associated with varicose recurrence.

Conclusions:

  • Phlebectomy limited to varicose tributaries is a safe and effective midterm treatment for chronic venous disorder.
  • Preservation of main superficial venous system veins is feasible and beneficial.
  • Systematic treatment of incompetent truncal veins is not essential for the majority of patients.