The incidence of varicose veins in the lower extremities has now reached about 5% of the total population in cities. Based on such a high incidence, vascular surgery has sprung up all over the country in recent years. Varicose veins of the lower extremities have become the leading disease in vascular surgery clinics or wards everywhere. Traditionally, varicose vein surgery is to strip the saphenous vein trunk while making multiple incisions to strip the varicose veins in the lower leg, which makes the patient’s hospital stay generally about a week due to the long incision, trauma and pain. In the last decade, minimally invasive treatments for varicose veins have gradually emerged. Endovenous laser closure (EVLT) is a procedure that uses a special wavelength laser to intervene in the saphenous vein trunk through fiber optics and then perform vein closure, a technique that to some extent avoids some of the complications associated with aspiration of the saphenous vein. For example, hematoma, saphenous nerve damage, etc. Other techniques that are similar to the laser are: radiofrequency closure and cryo-closure. These 3 techniques have in common the avoidance of saphenous vein aspiration and the least postoperative pain. However, they do not help with varicose veins in the lower legs and often have to be combined with traditional stripping surgery or other minimally invasive means. The recurrence of laser treatment in clinical practice is mainly related to the inexperience of the surgeon and the large caliber of the saphenous vein. The Trivex technique, designed for patients with extensive varicose veins in the lower leg, uses a subcutaneous light source to locate the varicose veins, which are then removed using a tare system. This technique solves the problem of varicose veins in the lower leg by making only 2 incisions in the lower leg. However, the aspiration technique is not applicable to the trunk of the great saphenous vein. Also, planar aspiration is not strictly minimally invasive; it appears to be a small incision, but the subcutaneous trauma is greater. Sclerotherapy injections require no anesthesia, no incisions, and are inexpensive. But there are many problems. The main sclerosing agents include sodium cod liver oil acid and polyglactin. However, there are great risks associated with sclerotherapy injections; one is that skin necrosis can result if the sclerosing agent injection solution leaks out. Second, once the sclerosing agent flows into the deep vein, it can lead to thrombosis and, in severe cases, pulmonary embolism. In recent years, the international sclerosing agent injection has made a series of improvements, such as: the emergence of microfoam technology (microfoam), which can make the occlusion effect better while reducing the concentration and dosage of sclerosing agent, greatly avoiding the past complications. However, sclerotherapy injections are very ineffective in the management of the saphenous vein trunk. The high recurrence rate in clinical practice and the factors of the domestic medical environment make it not widely used. Some small medical institutions to sclerotherapy injection packaged as “the latest therapy” “thrombolysis,” “interventional ablation” “nano therapy “and so on, with a certain degree of deception. At present, I think it is reasonable to use foam for postoperative residual or localized intravenous adjunctive therapy. The CHIVA procedure is the least invasive and least painful of all minimally invasive procedures.CHIVA is the French abbreviation for Cure Conservatrice et Hemodynamique de l′Insufficience Veineuse en Ambulatoire.CHIVA procedure is a reversal of the past destructive, waste The advantages of CHIVA are obvious: 1) it preserves the human saphenous vein trunk, which can be used for venous circulation and can be used as vascular graft material for other diseases in the future; 2) it can be performed under local anesthesia, and the patient can walk around after surgery without hospital observation; 3) it is almost painless after surgery because most of the blood vessels are preserved. Since most of the blood vessels are preserved, there is almost no pain after surgery, and the problem of nerve and lymphatic reflux damage that may exist in other surgeries is avoided. However, the CHIVA procedure is limited to general hospitals in China because it requires the surgeon to do the preoperative ultrasound venous examination and tracing, which is time-consuming and requires high skills. It is currently limited to patients with early varicose veins (saphenous vein caliber less than 5mm, elderly patients) with diabetes, hypertension, heart failure, etc. who cannot tolerate traditional anesthesia and surgery. Vascular surgery throughout China has made great progress and achievements in the treatment of varicose veins. However, in an overview, there are still some problems in the treatment of varicose veins in China. 1, the problem of excessive medical treatment. Varicose vein surgery is a more common surgery, and the preoperative diagnosis should be relatively simple and clear for most patients. It should be said that for an experienced vascular surgeon, a clear diagnosis can be made through physical examination. Thus, it seems that most patients do not need ultrasound and imaging of deep veins before surgery. In fact, a significant number of providers use deep vein angiography, putting patients at risk for a number of complications associated with angiography. For example, allergy to the contrast dose or thrombosis. It also significantly increases the cost of treatment for the patient and increases the waiting time for the procedure. However, venography is necessary for less experienced physicians or for more difficult clinical cases. It is also inappropriate for many providers to treat varicose vein surgery patients with antibiotics in the postoperative period. This is because saphenous vein surgery, in the absence of an infected ulcer, is an aseptic procedure and there is no indication for the use of antibiotics. These unscientific pre- or post-operative measures can be considered, to some extent, as “overmedication”. There are factors such as the doctor’s philosophy and academic level, and there is no denying that there are economic interests driving them. 2, the choice of surgery. There are many medical institutions that depend on the equipment that the institution has in choosing the procedure, not on the specific condition of the patient. As the equipment for varicose vein treatment is expensive, such as laser, radio frequency, planar suction and other equipment are more than hundreds of thousands of RMB, most of the hospitals only purchase one of the equipment. Therefore, in marketing, most hospitals only advertise how good the technology of their equipment is and exaggerate the scope of their treatment. It is not difficult to understand that some hospitals say that laser is the best means of treating varicose veins. Another hospital claims that radiofrequency is the best treatment for varicose veins. These statements are actually not scientific, as introduced at the beginning, each device has its advantages and disadvantages, and one of them or a combination of them should be used according to the patient’s specific condition. 3. Judgment of treatment effect. Strictly speaking, varicose veins are the clinical manifestation of many kinds of diseases, and varicose veins themselves are not harmful to the body except for the aesthetic change of the image, but some complications brought by the long-term development of varicose veins, such as: thrombosis, ulcers, edema, etc., are the main factors that affect the patients’ daily life. So the main purpose of treatment of varicose veins is to prevent these complications or for cosmetic purposes. The evaluation of the results of varicose veins should focus on the patient’s perception and improvement in quality of life, and the long-term results should be followed up. Some providers use sclerotherapy injections to make varicose veins disappear in the short term, but most patients have a recurrence after several years due to untreated diseased trunk veins. The evaluation of laser and radiofrequency procedures has also revealed over the years the possibility of recurrent recurrence of the saphenous trunk if not performed by experienced surgeons. Although there are only two incisions in the planar aspiration technique, the scope of trauma is mostly subcutaneous, so the postoperative subcutaneous bruising is more serious and requires longer bandage wrapping, which is difficult for Chinese patients to accept the relatively slow postoperative recovery. 4.Exaggerate the therapeutic effect of drugs. At present, the only clinically proven effective drugs for the treatment of varicose veins are Avalanche, Vein Spirit, and Desquamation. Other Chinese medicines, topical ointments, injections “blood activation drugs” are false products that fool the people. Even the above three drugs can only be used as adjuvant drugs in clinical practice, and cannot replace surgery. 5.Relapse caused by missed lesions. According to the ultrasound examination of a large number of postoperative recurrence patients, the reasons for recurrence were found to be more or less arranged as follows: (1) Omission of small saphenous vein lesion. The small saphenous vein is located at the back of the calf and is deep, so it is easy to be overlooked if preoperative ultrasound localization is not done. (2) Omission of traffic branch lesions. Ultrasound examination of the traffic vein is missed in most hospitals, and traffic vein lesions are an important factor in causing skin lesions and ulcers in the lower leg. (3) Omission of the saphenous vein trunk. Sclerotherapy injection and variation in trunk position can lead to recurrence after surgery. If one understands the above stated problems, one should know that one cannot blindly tell the patient what technique is best, but only what is most appropriate after examining the patient. A standard varicose vein treatment procedure usually takes less than a day in the hospital. (Except for patients with other medical conditions, of course.) Currently. Day Surgery, which is popular in Europe and America, has become more and more popular among patients because of its convenience and safety due to the advantages of special procedures, avoidance of spinal puncture or tracheal intubation, personal preoperative ultrasound positioning by experts, individualized design of surgical plan, early recovery, and no hospitalization. With the maturity of minimally invasive techniques and shorter hospital stays making varicose vein treatment unprecedentedly simple, patients who were apprehensive about surgery will revert to surgical treatment. It is expected that the number of varicose vein patients in vascular surgery will increase and the demands on the surgeon will increase.