(Disclaimer: This article is for scientific use only, and relevant information in the following content has been processed to protect patient privacy.) Abstract: This article describes a middle-aged patient who had suffered from varicose veins for many years and had redness and pain at the vascular prominence on the medial side of the knee 2 months ago. Ultrasound clarified the saphenous varicose vein combined with venous thrombosis. After diagnosis, surgical treatment of saphenous varicose vein – high ligation and stripping of the saphenous vein was adopted. 3 days of postoperative observation, the incision healed well and no significant complaints of discomfort and no varicose veins were seen at follow-up. [Basic information] Male, 56 years old [Disease type] Saphenous varicose vein [Hospital] Liaoning Provincial People’s Hospital [Consultation date] February 2022 [Treatment plan] Medication (low molecular heparin + mai zhi ling + injectable poppy bases) + surgery (high saphenous vein ligation + stripping) + physical therapy (medical compression stockings) [Treatment period] Hospitalization for 5 days, 3-month outpatient follow-up Treatment effect] The varicose vein disappeared, the thrombus was completely removed, and the incision healed well I. Initial consultation In February 2022, a 56-year-old middle-aged male patient came to the department with “varicose vein of the right lower limb for 10 years, aggravated with distension and pain for 2 months”. Two months ago, the patient suddenly developed redness and pain in the right lower extremity at the posterior popliteal vascular protrusion, unable to stand, and the symptoms were slightly relieved after elevating the affected limb. Recently, he has been eating well, sleeping poorly, having normal bowel movements and no significant weight loss. He was previously healthy. On examination: localized tortuous dilated veins were seen in the right lower limb, the right posterior calf was heavy, and a 4cm×3cm mass was seen behind the popliteal fossa, with a tough texture and blue-purple color, high skin temperature, palpable arterial pulsation, and fair sensorimotor function. The ultrasound of the saphenous vein of the right lower extremity suggested that the right saphenous vein was thrombosed, and no significant abnormality was found in the deep vein. Considering that the patient had a long duration of saphenous varicose vein, the local protrusion was obvious and showed venous aneurysm change, and due to long-term non-intervention, the saphenous vein thrombosis was secondary, but fortunately it did not develop into deep vein thrombosis in the lower limbs. In order to avoid recurrent episodes of superficial phlebitis, the treatment team decided to give the patient low-molecular heparin anticoagulation, promote venous reflux, and improve microcirculation with injectable poppy bases, etc. during the acute stage, and after the symptoms subsided, the patient was given a radical saphenous vein surgery – high ligation and stripping of the saphenous vein. The operation was successful, with complete stripping of the main trunk of the saphenous vein and removal of the thrombus. After the operation, the patient recovered well, and went down to the ground 6 hours after the operation. After 3 days of observation, the incision was changed and the incision healed well and the compression stocking was replaced. The patient was reexamined 1 month after the operation and the incision was well healed without redness and exudation, the patient was continued to wear medical compression stockings to promote venous reflux. 3 months later, the patient was reexamined and the saphenous varicose vein was cured with no obvious varicose vessels, no recurrence and no long-term complications, the result was satisfactory. IV. Precautions We are glad that the patient’s varicose veins disappeared and got the ideal treatment effect, but the patient also needs to pay attention to the following matters: 1. It is recommended to wear medical compression stockings after saphenous varicose vein surgery to help promote venous reflux and reduce swelling symptoms. For a period of time after surgery, do not perform heavy physical labor and do not walk for too long. 2. Saphenous varicose veins are easily combined with phlebitis and superficial vein thrombosis, but if the deep veins are not involved, there is no need for strict anticoagulation treatment, and surgery is still the first choice for such cases, so patients should not wait until saphenous varicose veins develop secondary thrombosis before coming to treatment, which will increase the difficulty of treatment. V. Personal insight Saphenous varicose vein is the most common type of lower limb varicose vein, most patients belong to the chronic course, no obvious symptoms in the early stage, with the continuous expansion of the saphenous varicose vein, the lower limb venous reflux obstruction further aggravated, will induce the emergence of saphenous vein thrombosis, phlebitis, ulcers and other serious complications. Once saphenous vein thrombosis occurs, active treatment is recommended, although long-term anticoagulation is not required, it is also necessary to prevent the further development of thrombosis and the formation of deep vein thrombosis in the lower extremities, with the risk of sudden death from pulmonary embolism. Therefore, once saphenous varicose vein is diagnosed, it is also important to actively intervene to deal with it according to the condition, and not to wait until there are complications before treating it.