The Preliminary Research Of Foam Sclerotherapy Joint Transilluminated Powered Phlebectomy For The Treatment Of Lower Extremity Varicose Veins

Lower extremity varicose veins is a relatively common peripheral vascular disease,The higher incidence of the disease in women is about14to51%, the male is about7to40%[1]. Long-term complications of varicose veins treatment goal is to minimize chronicsymptoms (intractable pruritus, heavy feeling, pain, fatigue and swelling), and preventionof chronic venous insufficiency (deep vein thrombosis superficial thrombophlebitisinflammation, pigmentation, eczema and ulcers), also need to take into account the effectof beauty treatment.Surgical treatment of varicose veins first began in the early20th century, the mainsurgical high ligation of the great saphenous vein or small saphenous vein stripping refluxof the great saphenous vein or small saphenous vein, removal of varicose vein[2].Although the exact effect of the surgical treatment, but the surgical procedure iscumbersome, and postoperative recovery time, postoperative easily with lower extremitypain and left obvious scar. With the improvement of updated medical equipment anddrugs, the treatment of varicose veins has entered a new era of minimally invasive[3].Treatment of trauma patients and after a short recovery time minimally invasive procedureis important and widely used in the day-to-day clinical work, the benefit of the majority ofpatients, especially the elderly and infirm can not tolerate traditional surgery patients cangetexcellent minimally invasive treatment. The minimally invasive treatment of thefollowing ways: foam sclerotherapy, transilluminated powered phlebectomy(TIPP),subfascial endoscopic perforator surgery (SEPS),endovenous laser ablation(EVLA),radio-frequency ablation (RFA),microwave coagulation intracavitary,catheter electrocoagulation,percutaneous continuous circumsuture (PCCS),point enucleation (PE)etc.Today the treatment of a variety of minimally invasive treatment of varicose veins,each with advantages. Encountered in daily clinical work to the hospital the s conditionof the patients with varicose veins are more complex, the majority of patients with severesymptoms or complications, through simple a minimally invasive treatment is oftendifficult to obtain a good effect,treatment of varicose veins trend is the developmentdirection of the comprehensive treatment[4]. In recent years, foam sclerotherapy by theattention, due to its simple operation, the exact effect. On the one hand, the foamsclerotherapy hardening occlusion of the saphenous vein and minor varicose veins groupto good effect, but poor efficacy of larger varicose vein group, postoperative prone tovaricose vein thrombosis group, after considerable influence beautiful. On the other hand,translucent vein atherectomy larger varicose veins group treatment effect is better, butthe most common complication of translucent vein atherectomy subcutaneous hematomaformation. Foam sclerotherapy of varicose veins can shrink, vascular endothelial promotethrombosis, blocking blood vessels and thus play a hemostatic effect. So before the linetransparent vein peeling surgery for varicose veins group injected foam sclerotherapy canreduce the amount of intraoperative bleeding and reduce the incidence of postoperativehematoma, at the same time transparent veins the atherectomy and can completelyremove varicose venous thrombosis group. Therefore, the foam sclerotherapy jointtranslucent atherectomy treatment the varicose veins process complement each other role.The study was to investigate foam sclerotherapy joint translucent atherectomy in thetreatment of varicose veins of the efficacy and complications.Provide the basis for thetreatment of varicose veins an ideal minimally invasive treatment options.Objective: Explore the the foam sclerotherapy joint translucent atherectomy treatmentefficacy and complications of varicose veins.Provide the basis for an ideal minimallyinvasive treatment of varicose veins treatment options.Methods: June to September of2012, the continuous entry our department90patients diagnosed with unilateral varicose veins explicitly hospitalized patients,36males and54females, aged32to65years with a median age of48years old. Randomly divided into A,B, C three groups of30cases. A group of patients received saphenous vein ligationcombined with foam sclerotherapy and transparent atherectomy; B patients receivedsaphenous vein ligation, trunk exfoliation and transparent atherectomy; saphenous veinligation group C patients receiving combinationfoam sclerotherapy technique. The threegroups were compared blood loss, operative time, recovery time and postoperativecomplications (superficial vein thrombosis group, pigmentation, superficialthrombophlebitis phlebitis, hematoma, postoperative pain, limb paresthesia, numbness,subcutaneous induration,infection, saphenous nerve injury, deep vein thrombosis,pulmonary embolism and severe drug allergy).After3months and6months follow-upDoppler ultrasound saphenous vein occlusion or recanalization and the form of aquestionnaire about postoperative recovery and complications, including again the CEAPclinical classification VCSS score,rated CIVIQ.Results: Blood loss: group C <group A <B group, the operation time: group C <A <Bgroup, the average postoperative recovery time: group C <A <B group. Postoperativecomplications: the number of cases of group B subcutaneous hematoma compared withA, C group, Group C appears superficial vein thrombosis compared with group A, groupB. After3months follow-up, three groups of CEAP clinical classification median Cl,compared with preoperative of C2-C6, in the median C4improved significantly (P<0.01). Doppler ultrasound A group saphenous vein occlusion rate of96.7%to100.0%group B, group C96.6%. The difference was not statistically significant (P>0.05). After6months follow-up, A group of great saphenous vein occlusion rate of90.0%, group B100.0%, C group was86.2%. The difference was not statistically significant (P>0.05). A,B, C three groups after surgery in March, June (VCSS) compared with the preoperativeclinical severity score decreased (P <0.01), A, B, C three groups was no significantdifference (P>0.05) A, B, C three groups after3month,6-month increase in the qualityof life questionnaire (CIVIQ) score than the preoperative (P <0.05), A, B, C three groupswas not statistically significant different (P>0.05). Conclusions: The curative effect of foam sclerotherapy joint transilluminated poweredphlebectomy for the treatment of lower extremity varicose veins is definite. Both reducethe intraoperative blood loss and postoperative hematoncus appear, and thoroughly solveLumps of venous thrombosis. The comprehensive minimally invasive treatment of lowerextremity varicose veins of the is ideal. And it is valuable to promote.