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Background Diagnosis and treatment of small saphenous vein (SSV) insufficiency is of utmost importance for relieving chronic venous insufficiency symptoms. Objectives To investigate the efficacy and safety of five different treatment approaches among patients with SSV insufficiency. Design and setting Two-center retrospective clinical study, conducted at cardiovascular surgery clinics in a local training and research hospital and a state hospital. Methods A total of 282 extremities of 268 patients with SSV insufficiency alone who were tr