Recent press reports have generated considerable interest in new techniques for treating varicose veins, claiming major advantages over conventional surgery. Their main aim is to reduce operative trauma and bruising associated with stripping, leading to quicker postoperative recovery. All these methods depend on the use of duplex ultrasound scanning during surgery to monitor obliteration of the vein lumen. Evidence about these new techniques is limited to case series and registry data, largely in private practice settings. Many vascular surgeons have therefore regarded the claims for their success with some scepticism, especially when press reports have portrayed conventional surgery in a falsely unfavourable light. The new methods may well offer some advantages, but they need further stringent evaluation.

Surgical stripping of the long saphenous vein is by far the commonest form of treatment for varicose veins, with more than 60 000 operations each year in England alone. The reasons for treatment range from complications like bleeding or ulceration to the much commoner complaints of discomfort or unsightliness. Indications for specialist referral are the subject of recent advice …