Font Size: Increase | Decrease

When is vein stripping used to treat varicose veins?

My mom had her varicose veins removed with vein stripping when she was younger and the results were excellent. I am thinking of having the same done, but now am reading that vein stripping is not really used as a treatment any more except in severe cases. Do doctors still offer vein stripping as a treatment for varicose veins? How frequently do patients choose vein stripping over other varicose vein treatments?


Doctors Answers (5)

Vein stripping of varicose veins is essentially an obsolete procedure, having been replaced with new techniques. Vein stripping, however, is still used by cardiologists who may remove one of the normal greater saphenous veins from a leg to be used to bypass a coronary artery blockage. Varicose veins are much larger than normal veins with frequent twisting, bulging and irregularity along their lengths. In treating a varicose vein(s), it is preferable to identify by ultrasound exam the source of venous reflux from the saphenous vein(s) or from a perforating vein as a first step, and then to close the problem vein(s). Closing a refluxing vein is usually done with either a fiber optic or radio frequency catheter inserted under local anesthetic as a simple day procedure. In select areas where a segment of the varicose vein is prominently bulging near the surface of the skin, a micro-phlebectomy will physically remove the vein segment through several 1 mm long incisions along the sides of the vein. With this technique, the segment of vein is removed with an immediate improvement in appearance. If the varicose vein is deeper and not visible at the surface, then other techniques are typically used. Only the segments of the varicose vein that are highly visible and likely to stain the skin and trap significant amounts of blood due to their size are considered for phlebectomy.

Pin stripping of saphenous veins is rarely done these days because we can treat saphenous veins with ablation just as effectively with a much faster recovery. We do however often do phlebectomies on varicose veins, which is similar to the stripping procedures just with smaller incisions.

Vein stripping was the main therapy to treat veins for years and years. Since the late 1990s minimally invasive treatments to close the veins have become the mainstay of treatment. These treatments are Endovenous laser ablation, VNUS closure or radiofrequency closure of the veins, Clarivein or mechanic-chemical ablation or any others. With these newer treatments, the patient can be treated in the office under local anesthetic and go back to work and normal activities almost immediately afterwards. These minimally invasive therapies have less side effects, due to no need for general anesthesia, lower risk of nerve injuries, blood clots, infection and bleeding risk. These procedures have less neovascularization or new veins forming after the vein is treated. Oftentimes with stripping, patients would develop extensive varices after the veins were stripped. This usually does not happen with these techniques. Vein stripping is still offered but most people choose the minimally invasive options due to the decreased risks, recurrence, side effects, scarring etc.

Vein stripping is no longer the treatment of choice for most patients because of the pain and complication rate. There are now safer and easier ways to treat with minimal, if any, complications.

Vein stripping is no longer standard of care. We see many people in our office who have not had the excellent results of your mother. Sealing the vein with laser is now the best treatment offered and has better long term results with little down time or discomfort. Stripping involves a trip to the hospital or surgery center, anesthesia, more pain and expense. EVLT is an office based procedure and your surgeon can remove the bulging varicose veins at the same time using microphlebectomy (tiny punctures through which the veins sections are removed).

Disclaimer: The information found on this website is intended to be general medical information; it is not a medical diagnosis or medical advice. Specific medical advice can only be given with full knowledge of all of the facts and circumstances of your health situation. You should seek consultation with a doctor familiar with your medical condition. Posting a question on this website does not create a doctor-patient relationship. All questions you post will be available to the public; do not include confidential information in your question.