Varicose veins in the lower extremities have a very high prevalence worldwide and are higher in women than in men. The curved vein masses not only affect the aesthetics, but in severe cases, they can lead to venous thrombosis, lower extremity edema, dermatitis and even non-healing skin ulcers. So, to deal with these different degrees of varicose veins, patients should choose conservative treatment or surgery? And what is the basis for deciding whether to have surgery or not? To what extent are your varicose veins in the lower extremities? As the saying goes, if you know yourself and your enemy, you will never lose a battle. The same is true for the treatment of varicose veins in the lower extremities, and we need to know the extent of the disease before we can choose the right treatment. Clinically, varicose veins of lower limbs are divided into seven stages from C0 to C6 according to different symptoms. The specific performance of each stage is shown in the figure below. Treatment of varicose veins in lower extremities, conservative or surgery? In general, patients with C0 and C1 stages have mild symptoms and can choose conservative treatment. It is mainly by wearing elastic stockings or taking medications to slow down the progression of the disease, but it cannot be cured. The veins of the lower limbs are like the water pipes of the building, which need to transport the blood in the veins against gravity to the occupants of the upper floors – the heart. Patients with varicose veins have problems with their blood vessels, so that the blood cannot all flow to the heart and accumulate in the lower limbs, at this time, promoting the blood to flow back upward through the action of external forces can only ensure that the blood does not pool at the bottom, but it does not The problem of water pipe itself is not solved. If varicose veins of lower limbs progress further and reach stage C2~C6, symptoms such as lower limb edema, skin pigmentation, rash and even skin ulcer appear, which seriously affect the normal life of patients, surgery is needed. Interventional vascular surgery at Peking University First Hospital adopts a minimally invasive stripping combined with electrocoagulation, which is less invasive and results in quick recovery after surgery. However, if the patient has complications such as lower limb superficial vein thrombosis, superficial phlebitis, or ulcers before surgery, the postoperative recovery will be slow and the efficacy will also be affected. However, clinical staging is not an absolute factor in determining whether a patient should undergo surgery, and the decision to operate is highly dependent on the patient’s own needs. Some patients with symptoms such as capillary dilation or mild varicose veins may choose minimally invasive treatments such as laser, radiofrequency or sclerotherapy for aesthetic reasons; in addition, some older patients with poor health conditions may also choose minimally invasive treatments. Laser treatment and sclerotherapy injection treatment also have their own disadvantages. Generally speaking, laser and sclerotherapy are not suitable for dealing with coarse blood vessels. Usually, laser or sclerotherapy is used to close the varicose vein branches after the main trunk of the saphenous vein is stripped. In addition, although sclerotherapy is less invasive, the treatment is not very complete and the chance of recurrence is high. Patients with varicose veins in the lower extremities should be seen as early as possible It is worth mentioning that some patients are very afraid of having surgery and some others choose not to treat varicose veins in the lower extremities because they think that they do not affect their daily life. It is only when different types of complications arise, such as thrombotic superficial phlebitis, hyperpigmentation, eczema, bleeding or even ulcers, that they come to the clinic. At this point, further treatment will be very ineffective and will only alleviate the patient’s symptoms and stop the progression of the disease, but the damage to the skin is irreversible and the already darkened skin will not change back to its normal color. Therefore, it is recommended that patients do not delay treatment and come to the clinic as soon as they have symptoms.