What is the gold standard method for treating the great saphenous vein?

The gold standard method for treating the great saphenous vein has traditionally been high ligation and division. This approach involves tying off the vein at its points of connection to the deep venous system and is aimed at preventing blood flow into the dysfunctional segment of the vein. By ligating the great saphenous vein, you eliminate a pathway for venous reflux, which is a common cause of venous insufficiency and associated complications. High ligation and division have been historically favored for their effectiveness in alleviating symptoms of chronic venous insufficiency and reducing complications such as varicose veins.

While other methods exist, such as stripping, sclerotherapy, and mini-phlebectomy, they may be used in specific contexts or when patients present with different conditions. Stripping is a procedure that physically removes the vein but is less commonly performed today due to the advent of minimally invasive options. Sclerotherapy involves injecting a solution that collapses the vein, which can be effective for smaller veins but might not address larger veins like the great saphenous vein as thoroughly. Mini-phlebectomy is a technique for removing surface veins and is typically used for varicose veins that are more superficial.

Thus, high ligation and division remains