ROCHESTER, Minn. - Getting rid of blue, gnarled varicose veins usually can be done with good results and no hospital stay.

The recent issue of Mayo Clinic Health Letter offers an overview of this condition and the outpatient procedures to remove or destroy them.

Varicose veins, which most often occur in the legs, result when the vein valves don't work properly. Bluishred, oxygen-depleted blood flows back into the legs and pools in the veins instead of taking a straight course back to the heart. The result is stretching and swelling of the veins. For most people, the concerns posed by varicose veins are cosmetic. Bulging gnarled veins aren't attractive. For others, varicose veins can cause an achy, heavy feeling in the legs that can be particularly painful when standing.

It's possible to remove or destroy varicose veins without harming blood flow because the blood reroutes itself. There are several treatment choices, and success rates are high.

Treatments for smaller varicose veins include:

. Sclerotherapy: Smalland medium-sized veins are injected with a liquid or foam that scars the veins, causing them to close off. This approach may require several treatments.

. Laser therapy: Best used on tiny varicose veins on the face, this involves moving a device over the skin that emits rapid pulses of intense, bright light that delivers heat to the veins, closing them off.

Treatments for largerbranch veins include:

. Catheter-assisted procedures using heat energy: A tiny incision is made in the skin, and a catheter is inserted along the length of a varicose vein. The catheter tip is heated with radiofrequency or laser energy. As it is slowly removed, the vein collapses and seals shut.

. Endoscopic vein surgery: Through a small incision in the upper leg, a thin tube (endoscope) with a tiny camera and surgical instrument at the tip is inserted into the problem area of a vein. The endoscope is used to visualize the veins and close them off. This approach is usually reserved for advanced cases.

. Ambulatory phlebectomy (fluh-BEK-to-me): This is the surgical removal of small to large veins through tiny incisions. It's an outpatient procedure, but activity must be limited during recovery.

. Vein stripping: Multiple small incisions are made along the course of a varicose vein. A hook instrument is used to pull the vein out, section by section. The incisions usually don't require stitches. This procedure requires general or spinal anesthesia and a longer recovery time.

Unfortunately, there are few options to prevent varicose

veins. And destroying problem veins doesn't prevent

veins from becoming varicose in the future. The main risk factors are genetics, age and being a woman. Past pregnancies and the fluctuations of estrogen that occur at different life stages contribute to the development of varicose veins.