Until recently, vein ligation and stripping was the standard treatment for large or perforated varicose veins. If the majority of the valves in the vein are healthy, ligation can be used to isolate the faulty valves and the rest of the vein may be left in place to continue circulating blood. If the vein is heavily damaged, however, it is usually removed, or stripped.

To strip a varicose vein, an incision is made above and below the damaged vein. Then, the vein is grasped and removed surgically. Most people are able to return to normal daily and recreational activities within a few weeks of the procedure.

Some common side effects of vein ligation and stripping include: temporary pain or discomfort, bruising, hematoma, numbness and (less frequently) wound infection. Vein stripping is an invasive procedure and shouldn't be performed on older patients because surgery may pose risks due to other existing medical conditions. It's also not appropriate for pregnant women or people with poor leg circulation, skin infections, blood-clotting defects or abnormal passageways between arteries and veins.