There is provided herein a system, device and methods for performing minimally invasive spider vein treatments. In some embodiments an apparatus for eliminating spider veins comprises a dual syringe mechanism that includes a pusher for pushing sclerosant materials into a target vein, and an extractor for extracting debris from a target vein; a needle for application into a target vein; and a Y-connector connecting each exit of the dual syringe mechanism to the needle. In some implementations the apparatus's dual syringe mechanism includes a locking mechanism to enable controlled advancing of the syringe pusher.