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 venous varicosity be measured by CT?

Venous varicosities can undergo CT imaging, but generally, it's best to avoid injecting medication into the varicose veins. If the varicosities are in the lower limbs, a routine ultrasound examination is usually sufficient. To perform venous imaging with CT, medication is typically administered through the upper limbs. It moves through the general circulation, enters the arteries, reaches the peripheral tissues, and then flows back through the veins to allow imaging of the lower limb veins. This process is time-consuming, laborious, and costly; therefore, CT is generally not used to detect lower limb venous varicosities. However, CT can be used to examine venous abnormalities in other areas, such as problems with abdominal veins.

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Written by Zhang Xue Min
Vascular Surgery
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How to treat varicose veins stage II?

If you're referring to the second stage of varicose veins, I'm not sure if you mean the clinical manifestation stage two, or if it's a recurrence after one surgery. Let's first talk about stage two varicose veins, which means there are visible and tortuous vein clumps. There are several main treatment methods for this condition: First, conservative treatment, which involves wearing medical compression stockings. If symptoms include soreness, heaviness, or cramping, some medications can be taken orally. Then, if there is a desire for surgical treatment, options like vein stripping, radiofrequency, or laser treatments are available. Some may involve sclerotherapy or another method called venous angle keratin treatment, specifically for stage two varicose veins. If it's a recurrence of varicose veins, we need to assess the specific situation. Some people might have had previous endovenous closure surgeries, and their veins are still present. In such cases, we can choose to redo the closure or opt for surgery to remove them. Another scenario is if the varicose veins have recurred after surgery. We need to investigate the cause. Some people might have iliac vein stenosis, and in such cases, treatment targeted at the iliac vein is necessary.

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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 Zhang Xue Min
Vascular Surgery
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Can varicose veins be detected by ultrasound B?

Ultrasound is currently the main examination method for varicose veins. It is non-invasive, safe, and affordable, making it one of the standard methods for assessing varicose veins. Besides viewing the superficial veins, it also allows visualization of the deformed deep veins within the muscles, enabling a basic assessment of the causes of varicose veins. Ultrasound now plays a crucial role in the treatment of varicose veins. Many new treatment methods, such as blood flow modulation techniques like wrist flexing, require high precision in ultrasound use. It is essential to locate the reflux points using ultrasound, and then specifically target these points for ligation.

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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.