| １．Non-invasive, Basic Treatment |
Elevate legs at bedtime.
Regular exercise, avoid standing for a long-time.
Wear compression stockings.
This treatment will not cure nor eliminate existing vein problems, however this will help slow the progression of the disease and alleviate symptoms |
| ２．Sclerotherapy |
Sclerotherapy is an injection of a solution (sclerosant) into the varicose vein and scar the inside lining of the vein. This causes the vein to close.
The procedure is an outpatient therapy that takes 10 to 15 minutes. Sclerotherapy is effective only for spider veins and some moderately-sized bulging veins but sometimes there can be a relapse. Temporary bruising or pigmentation change or staining at the injection sites can occur.
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| ３．Ligation |
In most cases, varicose veins occur when the valves are damaged. Surgical ligation is generally done to isolate the damaged valves. The vein is first tied off (ligated) by tying a small stitch around it to block blood flow. If only one valve in the ligated region is damaged, the ligated vein may be left in place. Sometimes this procedure is done with sclerotherapy.
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| ４．Stripping |
When numerous valves in a vein are damaged, the damaged vein must be stripped or removed.
To strip a vein, an incision is made below the damaged vein and the vein is grasped and surgically removed.
Most people are able to return to their normal daily and recreational activities within a few weeks.
Some common side effects from vein stripping surgery may include temporary pain or discomfort, bruising, hematoma, numbness, and less frequently, infection.
Vein stripping is an invasive procedure and should not be performed on older individuals for whom surgery poses a risk due to other medical conditions
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| ５．Stripping surgery with local anesthesia |
 Stripping surgery is very painful, therefore, full anesthesia is generally used, while local anesthesia can also be applied using specific anesthesia such as intravenous anesthesia or LA anesthesia.
Patients who undergo this surgery are able to go home the same day, but limited clinics/hospitals offer this surgery.
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| ６．The Radiofrequency (RF) procedure |
This procedure, known as VENUSTM, was developed in the US a little before the EVLT.
A special devise is positioned in the treatment vein and radiofrequency energy is then transmitted from the devise, heating the vein wall up to 85 degrees which causes contraction of the vein wall resulting in the closing down of the veins.
This procedure is invasive and effective, although inserting the device is complicated and the surgery is expensive.
As of Feb 2005, no clinic in Japan provides this treatment. The RF treatment, as well as EVLT, is not covered by health insurance.
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