I've had alllll sorts of varicose vein stuff.
First one I had stripped age 20. Private. Pulled out by groin, mega mega bruising all the way from ankle to knicker line. But brilliant outcome.
Second one, same vein on the other leg, at about 26. This time I had a lovely gp who told me to ham up the pain, oh the pain, yes yes I've tried compression bandages, etc and got me a spot on a clinical trial. I got put into a lucky dip of three treatments they were comparing - surgical stripping, laser and foam glue. Got the laser one. Incision by knee, push a laser on a stick up to groin, then slowly pill back while firing the laser and pressing down on the vein. Basically the idea is to burn and stick the vein together from the inside. That was an experience! For some reason (to do with the iron in your blood?) you can smell metal / pennies the whole time.
The laser results were ok, not amazing. My vein was much bigger and lumpier than your pic, and a couple of the lumps remained afterwards, so at one of my follow up appointments they did the foam glue injection - just a small needle straight into the bumpy bits and press down hard to stick.
If I had to recommend one I would go surgery. Much more painful and slower recovery but a much better outcome. There's still nothing on that leg, 17 years on, but the laser/glue leg has signs of them coming back only ten years later.