About Ambulatory Phlebectomy
Ambulatory phlebectomy is a procedure used to treat varicose veins that cause bulging in the skin surface. This is an office based procedure that is performed with local anesthetic (numbing medicine). After the skin is numb, segments of varicose veins are removed through tiny incisions. After the veins are removed, small bandages are placed for the incisions. Stitches or sutures are not needed.
The time for the procedure will vary with each patient. Most treatments are completed in less than one hour. Foam sclerotherapy is commonly performed on the same day as phlebectomy.
Prior to the procedure, the doctor will review your initial mapping ultrasound. While you are standing, the doctor will mark out the bulging varicose veins on your skin. Our staff will then clean your leg with a sterile solution and place sterile drapes with you lying on the procedure table. The doctor will numb your skin in a few areas and then use more numbing under the skin around the veins to be treated. Tiny incisions are then made and veins are removed through the incisions. Usually the only discomfort you feel is when the numbing medicine is first given. Some patients will take a Valium pill before the procedure or use nitrous oxide gas during the procedure. After the procedure is done, we will clean off your leg and place small bandages called steri-strips over the incision. No stitches are needed.
What to expect/ how long will it take?
The Ambulatory Phlebectomy procedure usually takes 30-60 minutes depending on how many varicose veins are present.
The success rate for phlebectomy is high, and the veins treated usually demonstrate excellent long-term results. However, patients may develop new varicose veins over time in veins that were once normal.
Risks/ Side Effect
Risks and side effects include:
- Bruising and swelling – this is the most common side effect.
- Inflammation – Our attempt is not to remove 100% of these bulging veins, yet to remove the majority of them. Inevitably small pieces of these veins will remain. That is totally normal and expected, however they will harden and create inflammation which can temporarily cause displacement of nerve tissue and create some discomfort. This is usually minor and will resolve.
- Skin numbness – this can be caused by damage to the sensory nerves near the treated veins, and usually improves over time.
- Allergy – possible allergic reaction to local anesthesia. Please let your provider know if you are allergic to avoid serious allergic complications.
- Bleeding – significant bleeding is unlikely. Blood thinners should be held if you are having phlebectomy performed.
- Clotting – blood clots are expected in the treated veins. Remember that inactivity can cause blood clots in deeper veins that can be serious. Frequent walking and use of compression stockings will help to prevent this.
- Temporary discoloration or change in skin appearance – treated veins can cause discoloration which will often improve over time.
Please discuss with your doctor all the potential risks and make sure you are comfortable with the treatment you have chosen before you proceed.
Is it Painful?
This procedure is a minimally invasive procedure. Most patients will have some mild discomfort for a few days after the procedure. Most find it does not affect their normal activities. There are rare occasions where pain can be stronger, which we can help with on an individual basis.
Following the procedure, compression stockings are placed over the dressings and will be worn for 24 hrs. At this point, we have you come back to the office for a bandage change. Incisions must be kept clean and dry for at least a week.
Covered by Insurance?
Phlebectomy is almost always covered by insurance.