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2(Varicose vein)

superficial vein

superficial vein deep system () superficial system superficial system deep system deep system superficial system deep system superficial systemsaphenofemoral valve groin saphenopopliteal

junction perforating vein

2.1

2

Primary varicose vein Secondary varicose vein deep venous thrombosis

2.1.1 Primary varicose vein

superficial system deep system saphenofemoral junction

2.1.2 Secondary varicose vein

deep venous thrombosis (DVT) DVT (-venous incompetence) DVT superficial systems superficial venous hypertension deep venous incompetence

deep system superficial system

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varicose vein great saphenous varicose vein Shortsaphenous varicose vein

2.2

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(Cramps)

2.3

(Thrombophlebitis) deep vein thrombosis pulmonary embolism

Chronic venous insufficiency (5)2.4

2.4.1

DVT secondary varicose vein DVT

2.4.2

long short saphenous veins Chronic venous insufficiency

2.4.3 Brodie Trendelenburg test

()

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Tourniquet (mid thigh) tourniquet tourniquet saphenofemoral junction

tourniquet tourniquet Saphenopopliteal Perforatorincompetence() tourniquet 2 tourniquet

pulse pulse ankle-brachial pressureindex

2.4.4

3 Varicography

superficial deep system(Recurrent

varicose vein) varicography invasive DVT

Continuous wave Doppler (CWD ) Doppler saphenofemoral junction

> 0.5 (prolongreverse of flow) valvular incompetence ()

DVT DVT DVT hyperpigmentation(lipodermatosclerosis)

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1.1Duplex evaluation B-mode ultrasound Doppler

1.2Ascending venography deep vein x-ray

duplex ultrasound

2.5 2.5.1 Conservative treatment

conservative treatment

2.5.2 (Sclerotherapy)

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(sclerosing agent sodium tetradecyl) (elastic bandage) 3 (great saphenous vein) saphenofemoralincompetence

2.5.3

2 1. (deep system) (superficial system) Saphenofemoral junction,saphenopopliteal junction above knee perforators2. venous stripping veinavulsion (recurrent varicose vein)

2.5.3.1 long saphenous vein

groin skin crease saphenofemoral junction (stripping ofthe long saphenous vein) saphenous nerve long saphenous

vein stripping

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vein stripper stabavulsions 2 3

2.5.3.2 short saphenous vein

10% short saphenous veinincompetence saphenopopliteal junction stab avulsion

saphenopopliteal junction vein stripper (sural nerve)

2.6

(recurrent varicose vein) (conservative treatment)90% 35%

20%

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1. Davies AH. Deep venous thrombosis and pulmonary embolism. In: Davies AH,

Beard JD, Wyatt MG, editors. Essential Vascular Surgery. London:

W. B. Saunders; 1999. p. 266-77.

2. Davies AH. Varicose Vein. In: Davies AH, Beard JD, Wyatt MG, editors. Essential

Vascular Surgery. London: W.B.Saunders; 1999. p. 252-60.

3. Davies AH. Venous ulceration. In: Davies AH, Beard JD, Wyatt MG, editors. Essential

Vascular Surgery. London: W.B.Saunders; 1999. p. 261-65.

4. Lamont PM, Shearman CP, Scott DJA. Venous disease. In: Lamont PM, Shearman

C, Scott DJA, editors. Vascular Surgery. Oxford: Oxford University Press; 1998.

p.118-29.

5. Stonebridge PA. Varicose vein, venous insufficiency and deep vein thrombosis. In:

Macintyre IMC, Smith RC, editors. The RCSE SELECT Program. Dundee: Dundee

University Press; 2000. p. 1-25.