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Endovenous ablation therapy

In this procedure, doctors close off varicose veins by using lasers or high-frequency radio waves within the vein to create intense heat. Your doctor will make a tiny cut near the vein and insert a small catheter. A device at the tip of the catheter heats up the inside of the vessel and closes it off.

Compared to an older procedure called vein stripping and ligation, in which veins are tied shut and removed through small cuts in the skin, ablation therapy closes off varicose veins but leaves them in place, resulting in minimal bleeding and bruising.

This therapy offers similar results in terms of improving appearance and symptoms. But people who have it feel less pain and get back to normal activities faster than those who undergo vein stripping and ligation.

Endovenous ablation therapy is minimally invasive and generally safe and complication-free. There are, though, risks, including infection, damage to the blood vessel, inflammation of the vein, and, rarely, heat damage to nerves, although this typically goes away in a short time. In extremely rare cases, blood clots that form in the veins can travel to the lungs.  

Endoscopic vein surgery

Typically, endoscopic vein surgery is used only when varicose veins become severe enough to cause skin ulcers or sores. Your doctor will make a small cut in your skin near the vein and use a tiny camera at the end of a thin tube to move through the vein. Then he or she will use a surgical device at the camera’s end to close the vein.

Ambulatory phlebectomy 

Ambulatory phlebectomy removes varicose veins closest to the surface of the skin through slit-like incisions. You’ll remain awake during the procedure, but the area around the vein will be numbed. It's an outpatient procedure, meaning there is no overnight stay.

First, the doctor will outline or mark the vein to be removed, then inject local anesthesia into the skin. Then he or she will make a tiny cut and use a surgical instrument or a large needle to hook the vein through the opening. Next, he or she will remove the vein segment by segment. Afterward, you’ll need to wear compression stockings for at least one week.