The difference between thromboangiitis obliterans and varicose veins

Written by Zhang Xue Min
Vascular Surgery
Updated on January 01, 2025
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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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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 Zhang Xue Min
Vascular Surgery
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Can varicose veins cause leg swelling?

Varicose veins are a broad concept that is clinically divided into seven grades, from 0 to 6. Grade 0 is normal, grade 1 involves some capillary dilation, grade 2 is marked by clear varicose veins, and from grade 3 onwards, edema can occur. Generally, the causes of varicose veins vary. Some people suffer from what is called simple superficial varicose veins, primarily due to problems with the valves in the superficial veins. These patients may experience mild edema, limited to the ankle area. Others suffer from secondary varicose veins, following dysfunction of the valves in the deep veins or communicating veins. In deep veins, there can be reflux or obstruction. In such cases, it is possible to cause compressible edema in the front of the lower leg, commonly known as shinbone area.

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Written by Chen Feng
Urology
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What are the symptoms of varicocele?

The symptoms of varicocele vary depending on the severity of the patient's condition. Clinically, most varicocele patients have no obvious symptoms or no symptoms at all, and varicocele is often discovered during physical examinations. A small percentage of varicocele patients exhibit noticeable symptoms. The primary symptom is a feeling of heaviness or discomfort in the testicles, especially after prolonged walking or standing. The pain becomes more pronounced, but it will decrease or even disappear after lying down and resting. Some varicocele patients may not show symptoms but present with infertility. Varicocele is then discovered through physical examinations or related medical tests.

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Written by Wang Shuai
Urology
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Symptoms of varicocele in the right spermatic cord

If it is a mild varicocele, most patients have no discomfort symptoms and it is not easily detected. If the varicocele reaches a moderate or even severe level, the patient may experience a sensation of dragging pain in the right testicle and a lax scrotum, especially after long periods of sitting, standing, or intense exercise. The pain and dragging sensation in the testicle will become more pronounced. However, the symptoms will gradually ease after lying down and resting. If varicocele persists for a long time, it can lead to a decline in sperm quality, causing male infertility, and can even result in testicular atrophy. If the above symptoms are present, it is necessary to promptly go to the hospital for an ultrasound examination to determine the diameter of the spermatic vein. A routine semen analysis may be necessary if there is a decline in semen quality. If needed, surgery may be required for treatment.

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Written by Zhang Xue Min
Vascular Surgery
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What are the effects of secondary surgery for varicose veins?

If varicose veins recur, we need to carefully investigate the cause of the recurrence and rule out problems in the deep venous system. If there is an obstruction in the deep veins, recurrence can occur quickly even after secondary surgery on the superficial veins. If the deep veins are only involved in venous reflux, surgery can still be performed, but it is hoped that medical compression stockings will be worn for a period of time after surgery. Otherwise, there is still a possibility of recurrence after the secondary surgery.