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Surgery is generally used to treat large varicose veins. Procedures include:

Ligation - Tying off of a vein
Stripping - Removal of a long segment of vein)
Ambulatory phlebectomy - Removal of large surface veins through small incisions that don't need stitches. You may get local, spinal, or general anesthesia. You'll probably go home the same day as the procedure.

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