At The Vein Clinic, we use various treatments to close off and remove varicose veins: ClosureFast, pharmaceutical ablation, VenaSeal, and ambulatory phlebectomy. Also known as microphlebectomy or stab phlebectomy, phlebectomy is very effective at removing the vein with minimal recovery. Plus, rather than waiting for the body to absorb the vein, with ambulatory phlebectomy we actually remove the vein from the leg.
What Is Ambulatory Phlebectomy?
Whereas other procedures such as ablation and VenaSeal seek to close off the varicose vein and then have the body absorb it over time, phlebectomy uses small, slit-like incisions in the skin to physically remove varicose veins. The incisions are tiny and don’t require sutures.
Am I a Good Candidate for Ambulatory Phlebectomy?
Phlebectomy may not be the best option for all varicose veins. Generally speaking, the veins need to be near the surface of the skin. It is better to treat deeper veins with ablation. Pregnant women and those with an active skin infection cannot have phlebectomy. If you’ve had problems with blood clots, you may not be a candidate.
Ambulatory Phlebectomy Procedure
Dr. Reynolds performs phlebectomy as an outpatient procedure at our offices. Here’s the process.
To start, Dr. Reynolds first marks the targeted veins, and then he numbs the area above the vein with a local anesthetic. This ensures there will be no pain during the procedure.
Dr. Reynolds will then make a series of tiny incisions above the vein. These incisions are incredibly small, about 2-3mm (roughly the size of a ballpoint pen tip). Through these incisions, Dr. Reynolds inserts a surgical hook. He places the hook around the vein and pulls it upward and out of the leg. Because the vein collapses, the piece is easily removed through the small incision. He repeats this down the length of the varicose vein, removing it piece by piece. The tiny incisions are covered with small bandages, and compression bandages are placed over the treatment areas. You’ll wear a combination of these compression bandages and then compression stockings for one week after your session.
Ambulatory Phlebectomy Recovery
Recovery is not difficult. You will likely have some bruising, swelling, and minor discomfort across the treatment areas. Additionally, the compression bandages and stockings will help to minimize this. Pain is minimal and can be handled with over-the-counter medications. The incisions don’t need sutures and are barely visible in a couple months. Amazingly, you can walk the same day as your treatment and immediately return to normal activities. You should hold off on strenuous exercise and any moderate to heavy lifting for two weeks. Patients usually return to work the next day.
Results of an Ambulatory Phlebectomy
Your varicose vein has been removed, so your results are immediate and permanent. There will be some slight swelling and minor bruising, but this resolves within a few days. There can be some change in skin pigmentation over the removed vein, but this also clears quickly. Your vein is gone for good, although you may develop other varicose veins in the future.
Risks of Ambulatory Phlebectomy
Ambulatory phlebectomy with Dr. Reynolds is a safe, effective procedure. It is easy to take for virtually all patients. There are some potential risks, but they are rare:
- A nerve injury to the skin, though these usually resolve with time
- Severe bleeding or swelling
- Numbness or pain in the feet
- Thrombophlebitis (inflammation causing a blood clot)