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The mode of treatment of varicose veins has changed substantially over the last 20 years. Minimal invasive techniques have been established and seek the most gentle and safest way of treatment. Ultrasound is the basic instrument to guide these techniques. Endothermal ablation with laser or radiofrequency has become the standard technique for treatment of axial reflux. It requires local tumescence anaesthesia. Other, tumescencless techniques have been developed and established. Today there are many minimal invasive ways to treat varicosity. The treatment strategy can be tailored to the individual patient.