Is vein varicose treatment better with injections or surgery?

Written by Zhang Xue Min
Vascular Surgery
Updated on September 06, 2024
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Venous sclerotherapy involves injecting a sclerosing agent and is a relatively good and minimally invasive treatment method. Its advantages include being minimally invasive and even suitable for outpatient surgery, with low costs. However, there are drawbacks; one is that the medication might enter the deep veins, causing deep vein thrombosis. If the dosage is too large, it could reach the lungs, causing pulmonary embolism. Additionally, the medication might seep into surrounding tissues, causing inflammatory reactions. Some patients may experience temporary hyperpigmentation. Surgical treatment is a more traditional method, but it depends on the specific situation. Generally, it causes more trauma than sclerotherapy and usually requires some level of anesthesia. Surgery entails a certain amount of blood loss, and like other methods, it cannot prevent recurrence.

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Written by Zhang Xue Min
Vascular Surgery
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The difference between thromboangiitis obliterans and varicose veins

Firstly, these are two completely different diseases. Thromboangiitis obliterans is an inflammatory vascular disease involving the medium and small veins and arteries, causing migratory superficial phlebitis and leading to the obstruction of the veins, as well as some obstructions in the lower limb arteries. Thus, thromboangiitis obliterans includes some obliterative diseases of both arteries and veins, the cause of which is an autoimmune inflammation. Varicose veins are one of the most common vascular surgical diseases. They primarily manifest as tortuous, clustered, and dilated superficial veins of the lower limbs. This condition does not involve arterial changes, but varicose veins can progressively worsen and may lead to pigmentation and ulceration, which at that time necessitates differentiation from arterial ulcers. Generally, the ulceration in varicose veins is located in the "gaiter area," which is the area covered by a boot when wearing one, including the lower one-half to one-third of the lower leg. Most of the ulcers from varicose veins primarily appear above the inner ankle. The ischemia caused by thromboangiitis obliterans leads to a dry-type ischemia, where the limbs can gradually become dry, shriveled, atrophied, and blackened, with ulcers typically beginning from the extremities.

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Written by Zhang Xue Min
Vascular Surgery
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What does it mean when varicose veins occasionally have blocked blood flow?

The so-called varicose veins are caused by blood circulation blockages, which likely refers to local thrombus formation, leading to feelings of congestion in lower limbs, or caused by compression from above, such as tight clothing, exacerbating the obstruction of blood flow. This might result in increased surface tension of varicose veins in the lower extremities. Additionally, there might be some pain upon pressing, or even spontaneous pain. In such cases, differentiated treatment is required. For instance, if the issue is due to compressive clothing, like tight-knee socks or pants legs that are too tight, simply relieving the pressure should suffice. However, if a thrombus has formed causing increased local tension, pressing or massaging must be strictly avoided, as there is a risk the thrombus might dislodge and potentially lead to pulmonary embolism.

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Written by Zhang Xue Min
Vascular Surgery
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Why does varicose veins sometimes feel like needle pricks?

In cases of varicose veins, the blood flow in the varicose veins is relatively slow. This blood, having undergone gas exchange, contains less oxygen and more carbon dioxide. If such blood remains in a local area for an extended period, it can potentially stimulate the nerves to some extent. Sometimes, including in varicose veins, if the blood flow pressure within these veins increases, it can also stimulate the nerves in the outer membrane of the blood vessels, leading to abnormal nerve discharges. Such incidents can manifest as brief, pin-like pain, not particularly intense, resembling the sensation of a needle prick. This condition is quite common and generally holds no special significance.

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Written by Zhang Xue Min
Vascular Surgery
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Can you run if you have varicose veins in your lower legs?

Patients with simple varicose veins can run. The movement of muscles, especially during running when the calf muscles are active, can compress the deep veins, facilitating the emptying of these veins. This benefits the flow of blood in the superficial veins through the communicating veins back to the deep venous system, thus participating in the systemic circulation. Therefore, patients with varicose veins in the calves can still run in the majority of cases. However, there are exceptions. If a person experiences significant muscle pain, it is important to be cautious as there may be a thrombus in the muscle veins. If there is a thrombus in the muscle veins, and the return flow in the deep veins is obstructed, this may also cause varicose veins. In cases of fresh thrombosis, running might lead to the detachment of the thrombus. Thus, patients in such conditions are advised not to run until further evaluation is confirmed by an ultrasound examination.

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Written by Chen Feng
Urology
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Can varicocele heal itself?

Varicocele generally cannot be cured, and most patients with varicocele do not have any symptoms and only discover their condition during physical examinations. Such patients can temporarily be under observation, but they should regularly have their varicocele rechecked and also have their semen quality tested. If there are abnormalities in semen quality, timely surgical treatment is necessary. Clinically, a small number of varicocele patients exhibit significant symptoms, typically presenting as discomfort and pain on the affected side of the scrotum, especially after long periods of walking or standing, with pain becoming more pronounced. In such cases, prompt surgical intervention is generally necessary, and surgery can also improve the quality of the patient's semen.