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Varicose veins are enlarged, dilated veins, most commonly located in the legs. There are several ways to remove or treat these damaged veins.

Who is a candidate for the procedure?

Surgery can be done for most people who want to have varicose veins removed. Surgery is usually advised if symptoms are severe and fail to respond to other therapy. Many people have surgery because they dislike the way the veins look.

How is the procedure performed?

There are a number of ways to remove or treat varicose veins. The procedure used depends on their location and severity as well as the preference of the healthcare professional.

The procedure may be done with local or general anesthesia. Local anesthesia means that numbing medication is injected under the skin where the cuts will be made. General anesthesia means the person is put to sleep with medications, feels no pain, and has no awareness of the procedure.

Procedures used to treat varicose veins include:

• surgical ligation and stripping, which is often used for more severe varicose veins. Certain veins in the leg are tied off, which is called ligation. A small stitch is tied around a vein to block blood flow through it.

• phlebectomy, or removal of the vein through cuts in the skin. Phlebectomy is similar to ligation and stripping, except that smaller pieces of vein are removed with a small surgical hook.

• sclerotherapy, which permanently closes or collapses the veins with chemicals. Certain irritating chemicals can be injected directly into the varicose veins. This damages the veins and causes them to permanently collapse. This is often performed for the small unsightly veins in the calf—commonly called spider veins.
• electrodessication, which is the use of electrical current to permanently seal varicose veins
• laser therapy and intense pulsed light therapy, which use laser beams or high intensity light to destroy varicose veins

What happens right after the procedure?

After the procedure, the person will watched closely for a short time. Vital signs, blood pressure, pulse, and breathing will be checked frequently. Bandages are usually placed over any cuts.

Those who have had more complex surgery may need to stay in the hospital overnight. Most other people will be able to go home a few hours after surgery. If sedatives or general anesthesia were used, someone else must drive the person home.

What happens later at home?

The healthcare professionals will explain care of any bandages before the person goes home. Swelling and bruising are common when cuts are made. Though the person will generally have mild pain that responds to over-the-counter pain medications, a prescription pain medication may be given in case the person needs it.

Most people are able to return to normal activity with 3 or 4 days. While these procedures do cure varicose veins, new varicose veins can appear and need treatment. If one returns to a job where some standing is required, then it is recommended that he or she wear support hose or elastic stockings, initially to promote complete healing and later to prevent recurrence of the varicose veins.

What are the potential complications after the procedure?

Like any surgery, varicose vein removal can be complicated by bleeding, infection, or reactions to any pain medications used. Small areas of skin numbness can be caused by nerve damage, and these are sometimes permanent. Blood clots may form in the remaining veins, a rare but possibly serious problem. Most people have few or no problems and recover without difficulty.