3 alternatives to standard varicose vein treatment.

Discuss minimally invasive procedures with patients considering surgery for treatment of chronic venous insufficiency. Thermal ablation, in particular, has higher success rates than vein stripping. Consider endovenous chemical ablation for treatment of tortuous saphenous tributary varicosities that cannot be treated with thermal ablation. Foamed sclerosant, injected under ultrasound guidance, allows for direct visualization and has equivalent efficacy rates when compared to venous stripping. Pregnancy, active deep vein thrombosis, poor health with limited mobility, and severe peripheral vascular disease are contraindications for both thermal and chemical ablation.