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Non-Surgical Treatment

For some people, varicose veins are only a minor inconvenience. Treatment may or may not be needed. But you may find that your varicose veins are causing pain and discomfort. Sometimes the condition leads to more serious problems. And varicose veins can get worse over time. So you may find that treatment is indicated.

Compression Stockings

Your doctor may first suggest a method that does not require surgery to relieve your symptoms. In some cases, he or she may prescribe the use of compression stockings.

  • These elastic stockings work to squeeze your veins and stop excess blood from flowing backwards.
  • These stockings also work to heal sores and prevent them from coming back.
  • You may have to wear the stockings every day for the rest of your life.

Minimally Invasive and Surgical Treatments

You may find, however, that stockings don't work or are too cumbersome to deal with over a long period of time. If this is the case, you may want to consider a surgical or minimally invasive treatment. There are three major treatments available: microphlebectomy surgery, radiofrequency ablation and vein stripping.

Microphlebectomy Surgery

  • Also known as small incision excision or small vein avulsion.
  • Minimally invasive procedure using tiny incisions or punctures to hook and remove large varicose veins located close to the skin's surface.
  • Performed in the operating room often under local anesthesia with sedation.
  • Does not require the use of stitches as the punctures are closed with bandages.
  • The technique leaves virtually no scars and you can return to normal activities almost immediately.
  • Risks involve some discomfort at the site and some mild bruising.
  • Many veins may be able to be treated during one session.

Radiofrequency Ablation

  • Also known as Venous Closure.
  • Performed in the doctor's office.
  • A thin, flexible tube known as a catheter is inserted into your varicose vein and guided by ultrasound.
  • A radiofrequency device at the tip of the catheter heats the walls of the vein, collapsing and sealing the vein.
  • You are awake during the procedure, but the area being treated is numbed by a local anesthetic.
  • No sutures are needed.
  • This procedure is usually completed within an hour, and you are able to go home the same day.
  • Following the procedure, you will need to wear a compression stocking to help reduce bruising and tenderness and to minimize the rare possibility that blood clots may form.
  • You may resume most normal activities immediately.
  • Afterward, you should not spend too much time in bed, as this can increase the risk of blood clots.
  • This treatment may not be suitable for some varicose veins.

Vein Stripping

In some cases, vein stripping surgery may be required.

  • Typically performed if you are not a candidate for the less invasive VNUS closure.
  • Your surgeon first makes a small incision in the groin area and usually another one in your calf, below your knee.
  • Then he or she ties off all major varicose vein branches associated with your saphenous vein, the main superficial vein in your leg.
  • Your surgeon then removes the saphenous vein.
  • Vein stripping is done in the operating room with general anesthesia but typically does not require a hospital stay.
  • You will likely go home the day of your surgery and should be able to return to normal activities within a few days.
  • To control swelling and bleeding and promote healing of the surgical wounds, the treated areas may be wrapped with elastic bandages.
  • Compression stockings may also be used and a mild pain reliever may be prescribed.
  • You will also be told to take several short walks each day in the postoperative period.

Contact Information

Cardiovascular Medicine
Division of the CardioVascular Institute
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215