Ambulatory Phlebectomy

This relatively minor surgical procedure is often conducted at the same time as a laser or radiofrequency ablation. Ambulatory phlebectomy is performed by making tiny incisions that rarely ever require stitches to heal. The bulging vein is then extracted through these tiny incisions, and, after the vein is removed, a small bandaid is placed over the incision and a compression bandage is applied. As with our other methods, the body will naturally reroute the blood supply to other, healthier veins.

When is this procedure used?

Ambulatory phlebectomy is used for the treatment of tortuous varicose veins and tributary veins off the main great or small saphenous vein. Ambulatory phlebectomy is most often utilized for varices below the knee in the calf area. In the calf, the saphenous nerve is near the saphenous vein, and in the mid-calf the nerve moves away from the vein. Damage to the saphenous nerve causes some transient numbness, so in order to avoid injuring the nerve, phlebectomies or ultrasound-guided foam sclerotherapy is often utilized as an adjunct to endovenous ablation. Phlebectomies are also commonly used to treat tortuous veins on the side anterior or lateral aspect of the thigh.

What should I expect from ambulatory phlebectomy?

Ambulatory phlebectomy is a minor surgical procedure performed in an office-based, outpatient setting using local anesthesia. Complete surgical removal of varicose veins segments may be achieved in a single session or in separate sessions depending on the location and how extensive the network of veins is. Because they heal quickly, after six-to-twelve months the small slit-like incisions should be practically imperceptible. Recovery time is immediate, however, temporary bruising or swelling may occur after the procedure. Ambulation after this surgery is encouraged, and a post-operative bandage is kept in place for 24 hours before being replaced with daytime compression stockings for one-to-two weeks.

What kind of results are achieved?

Around 90% of patients achieve long-term success, although new varicose veins can develop in the future in different locations as with any other therapy. Some patients may experience some tenderness over a treated vein due to trapping of blood. This is treated in the office by removing the trapped blood under local anesthesia.

What should I do after my ambulatory phlebectomy treatment to ensure vein health?

Exercising, maintaining a healthy body weight, and avoiding prolonged periods of sitting or standing will help ensure your vein health following ambulatory phlebectomy. If you notice any new veins or your condition isn't improving, reach out to your CVR doctor.

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