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Can ambulatory microphlebectomy be used to remove any varicose vein?

Microphlebectomy

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Microphlebectomy is a commonly used to remove large bulging veins. The procedure is sometimes referred to as ambulatory phlebectomy. Although microphlebectomy is a type of varicose vein surgery, the incisions required during the procedure are small and do not require any stitches. The risk of bleeding or infection is much lower with microphlebectomy than with older forms of vein surgery. Scarring is usually minimal to non-existent since the incisions are small.

Before a successful microphlebectomy can be performed, a doctor at a vein treatment center will administer a thorough physical examination and history. The vein expert will also use an ultrasound to examine the varicose veins, blood flow and valve function prior to treatment. Medical imaging technology allows doctors to determine which veins need to be treated, as well as their exact location and size.

Microphlebectomy is a safe procedure that may be done in-office using strictly local anesthesia. Patients will not need to be put under general anesthesia. A microphlebectomy procedure typically lasts no more than an hour. Most patients are able to return to work the day after the procedure depending on how physically demanding their jobs are.

When the microphlebectomy procedure begins, a medical professional who specializes in varicose vein treatment marks the bulging veins using a skin marker. This skin marker makes it easier for the doctor to see the veins during the varicose vein removal process. The skin must be disinfected and thoroughly cleaned for the procedure. A local anesthetic is also injected around the vein. Some patients may wish to take an oral medication to relax prior to the microphlebectomy.

Once the body has been prepped, small surgical incisions approximately 2 to 4 millimeters in length are made where the veins had been marked. A small hook is then inserted through the incision and is hooked around the bulging vein. As the doctor pulls the vein out, patients typically do not feel pain, but may experience a mild pulling sensation. This process can be repeated multiple times for additional varicose vein removal. 

The patient’s leg is bandaged after the microphlebectomy procedure. Recovery time after microphlebectomy is short. During the recovery process patients wear compression hosiery for about 1-2 weeks. These compression stockings are designed to promote good blood flow in the legs as the varicose veins heal. People can typically resume normal activities soon after the procedure, and aerobic activities such as walking, biking or treadmill are often recommended starting right after the procedure. Soreness and bruising may be noticed after the procedure, but these are typically mild and temporary side effects. Over the counter pain medication such as ibuprofen can help manage post-operative pain.

After a microphlebectomy has been performed, it is common for a vein specialist to also recommend sclerotherapy injections to treat any remaining veins.

Contact a vein treatment center listed on DoctorQA if you have questions about microphlebectomy or ambulatory phlebectomy.

 

Reviewed by Steven E. Zimmet, MD, RVT, FACPh
Editor of Phlebology
President, Zimmet Vein & Dermatology
Past-President, American College of Phlebology

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