What is Stab Phlebectomy for Varicose Veins?

Medically reviewed by Sanjiv Lakhanpal, MD, FACS , and Khanh Nguyen, DO, RPVI, on November 16, 2025

If your legs ache at the end of the day, or those twisted, rope-like veins have become impossible to ignore, it may be time to look beneath the surface—literally. 

Varicose veins aren’t just a cosmetic concern; they’re often a visible sign of venous insufficiency, a chronic condition in which weakened vein valves allow blood to pool in the legs instead of flowing smoothly back to the heart. The result? Swelling, heaviness, fatigue, and veins that seem to rise and bulge with every passing year.

Thankfully, modern medicine offers elegant solutions. One of the most effective and least invasive is stab phlebectomy, also known as ambulatory phlebectomy, a technique designed to remove troublesome surface veins through micro-incisions so small they often don’t require stitches.

For this article, we consulted Center for Vein Restoration (CVR) vein experts, Dr.Sanjiv Lakhanpal and Dr. Khanh Q. Nguyen. We explored what stab phlebectomy is, who benefits most, how it differs from other outpatient vein treatments, and why working with a board-certified vein specialist at Center for Vein Restoration (CVR) is the best way to achieve lasting relief.

📞 Call Center for Vein Restoration at 240-249-8250
📅 Or book online HERE

Understanding Vein Disease, Venous Insufficiency, and Varicose Veins

Healthy veins rely on one-way valves to keep blood moving upward toward the heart. When those valves weaken due to a condition called venous insufficiency, blood flows backward and collects in the lower legs, increasing pressure inside the veins. Over time, that pressure causes veins to enlarge and twist, leading to visible varicose veins, leg pain, and swelling.

According to the Mayo Clinic, this backward flow can also result in cramping, skin changes, or ulcers near the ankles if left untreated. The Mayo Clinic Health System emphasizes that varicose veins are not merely a cosmetic issue but a circulatory one, an early warning that the venous system needs attention.

At CVR, every patient receives a thorough ultrasound evaluation to identify both surface-level and underlying vein problems. This diagnostic precision helps your vein doctor recommend the right treatment for your unique anatomy and symptoms.

📍Find your nearest CVR location 

📅 Schedule a consultation today to learn whether your leg pain, swelling, or visible veins may be signs of venous insufficiency.

What Is Stab Phlebectomy?

Despite its intense-sounding name, stab phlebectomy is a refined, gentle procedure for removing surface varicose veins. The term “phlebectomy” means surgical vein removal, while “stab” refers to the tiny, puncture-like openings, often no larger than a freckle, through which the vein is carefully removed.

• The vein specialist numbs the area with local anesthesia.
• Through a series of small micro-incisions (1–3 mm), the diseased vein is removed in short sections using a fine hook.
• Because the cuts are so small, no stitches are required, and scarring is minimal to nonexistent.
• Patients walk immediately after the procedure and can return to normal activities within a day or two.

As RadiologyInfo.org explains, stab phlebectomy offers both medical and cosmetic benefits and eliminates painful, bulging veins while improving leg appearance.

💡 CVR Tip: Stab phlebectomy is often performed alongside other treatments, such as endovenous ablation, to ensure that both the root cause (refluxing veins) and the surface symptoms (bulging veins) are fully addressed.

Who Is a Good Candidate for Stab Phlebectomy?

A stab phlebectomy is best suited for individuals with visible, bulging surface veins that cause discomfort, heaviness, or swelling. You may be a candidate if:

• Your varicose veins are close to the skin surface and tender or aching.
• You’ve undergone other vein procedures (like ablation) but still have prominent surface veins.
• You want a minimally invasive, quick-recovery solution for vein problems that affect comfort or confidence.

Before recommending a phlebectomy, your Center for Vein Restoration vein specialist will perform a painless ultrasound to determine whether deeper veins show reflux (backward flow). Treating only surface veins without addressing underlying venous insufficiency can lead to recurrence, according to the Mayo Clinic.

🤔Wondering if you’re a candidate for stab phlebectomy?
Stop guessing! Meet with a board-certified vein doctor at CVR for a personalized treatment plan designed to restore comfort and circulation.

📞 Call Center for Vein Restoration at 240-249-8250
📅 Or book online HERE

How Does Stab Phlebectomy Differ from Other Vein Treatments?

Not all vein treatments serve the same purpose. Each technique addresses a different aspect of vein disease:

Sclerotherapy

• Involves injecting a chemical solution into small varicose or spider veins.
• The vein collapses and fades over time, but is not removed.
• Best for smaller, non-bulging veins. 

Endovenous Thermal Ablation (Laser or Radiofrequency)

• Uses heat to close larger refluxing veins through a catheter.
• Redirects blood to healthy veins but leaves the treated vein in place.
• Often performed alongside phlebectomy for optimal results. 

Stab Phlebectomy

• Removes the problematic vein entirely through tiny incisions.
• No heat, chemical injection, or large cuts involved.
• Minimal downtime, little to no scarring, and immediate aesthetic improvement. 

The distinction is simple: while ablation and sclerotherapy seal the vein closed, stab phlebectomy physically and comfortably removes it, making it particularly effective for veins that bulge at the surface.

🦵 CVR Insight: By combining the latest minimally invasive procedures, our physicians can treat all levels of venous disease, from hidden reflux to visible varicose veins—under one roof.

What to Expect Before, During, and After the Procedure

Before Treatment
Your CVR vein doctor maps the affected veins using ultrasound to guide precise treatment planning.

During Treatment

• Local anesthesia is used to numb the leg.
• The specialist makes several micro-incisions to remove the vein in sections.
• The process typically takes 30 to 60 minutes, depending on the number of veins.

After Treatment

• Compression stockings are applied immediately to promote healing and prevent swelling.
• You can walk out of the office and resume light activity the same day.
• Mild bruising or tightness is normal and usually subsides within a week or two.  

💬 Recovery Tip from CVR: Walking after your procedure encourages healthy circulation and helps reduce soreness. Our team will guide you through every step of the recovery process.

How Does Stab Phlebectomy Differ from Vein Stripping?

For many people, the term “vein removal” still brings to mind the old-fashioned vein stripping surgeries their parents or grandparents endured: painful, hospital-based procedures with long recoveries and visible scars. Those experiences unfairly gave today’s office-based stab phlebectomy a bad reputation it doesn’t deserve. 

Modern phlebectomy is an elegant, outpatient treatment performed with precision and minimal discomfort, offering dramatically better results with virtually no downtime.

Differences between the two procedures include:

• Level of Invasiveness
  • Vein Stripping: Requires large surgical incisions and general or spinal anesthesia.
  • Stab Phlebectomy: Uses tiny micro-incisions (1–3 mm) under local anesthesia—no stitches needed.
• Procedure Scope
  • Vein Stripping: Removes or ties off the entire saphenous vein (a major vein in the leg).
  • Stab Phlebectomy: Targets only the bulging surface veins that cause discomfort or cosmetic concern.
• Recovery Time
  • Vein Stripping: Involves significant bruising, pain, and a recovery period lasting several weeks.
  • Stab Phlebectomy: Patients walk immediately after treatment and return to regular activity within 1–2 days.
• Scarring and Cosmetic Results
  • Vein Stripping: Larger incisions can leave visible scars and tissue inflammation.
  • Stab Phlebectomy: Minimal or no scarring due to micro-incision technique.
• Effectiveness and Modern Use
  • Vein Stripping: Effective but largely outdated, now reserved for rare cases like venous aneurysms.
  • Stab Phlebectomy: A modern, outpatient alternative with faster healing and long-lasting results.

Why Choose a Vein Specialist at Center for Vein Restoration

A successful outcome starts with the correct diagnosis. CVR’s board-certified vein doctors are vascular experts who evaluate not just what’s visible on your skin, but also what’s happening beneath it.

At CVR, your care includes:

• Advanced duplex ultrasound imaging to detect hidden venous insufficiency
• Customized treatment plans that address both surface and deep vein disease
• Follow-up care to ensure results that last

If vein disease has begun to limit your comfort, confidence, or mobility, the board-certified vein specialists at Center for Vein Restoration can help. With over 120 clinics nationwide, CVR offers expert diagnosis, advanced treatment, and compassionate care designed around you.

🌿 Healthy legs are within reach. Schedule your consultation today at Center for Vein Restoration🔽

Frequently Asked Questions About Stab Phlebectomy 

1. Is stab phlebectomy painful?
Most patients describe stab phlebectomy as virtually painless. The procedure is performed under local anesthesia, so you’ll feel only mild pressure or tugging, and most people resume normal activities within a day or two.

2. How long does it take to recover from a stab phlebectomy?
Recovery is typically quick. Most patients walk immediately after the procedure and return to work within 24 to 48 hours. Bruising or mild swelling may occur but usually fades within one to two weeks.

3. Will my varicose veins come back after stab phlebectomy?
The treated veins are permanently removed so that they won’t return. However, new varicose veins can develop over time if underlying venous insufficiency persists, which is why a comprehensive evaluation at Center for Vein Restoration is essential.

4. How is stab phlebectomy different from laser vein treatment or sclerotherapy?
Unlike laser ablation or sclerotherapy, which seal veins closed, stab phlebectomy physically removes the diseased vein through tiny micro-incisions. This makes it especially effective for larger, bulging veins that don’t respond to injectable or heat-based treatments.