How does venous ultrasound assist in the diagnosis of varicose veins?
Transilluminated powered phlebectomy, or TIPP, is a method of varicose vein removal often used as an alternative to traditional phlebectomy. Large varicose veins are bulging veins that have become enlarged as a result of weakened vein walls or malfunctioning valves. Bulging varicose veins may be of cosmetic concern, or may cause leg symptoms such as pain, heaviness and/or leg fatigue, swelling, skin inflammation or venous leg ulcers.
During a traditional phlebectomy, a doctor makes several small incisions and inserts a small hook device to pull out the varicose veins. Transilluminated powered phlebectomy uses transillumination lighting to visualize the veins. Local anesthesia is also used to maximize comfort during the procedure. The probe is inserted through small incisions into the area of the varicose veins. The varicose veins are then broken up and aspirated. Compared to standard phlebectomy there are fewer incisions during transilluminated powered phlebectomy, and the operative time is probably less with TIPP. However, some reports suggest there may be more bruising and as well as more pain in the recovery phase as compared to standard ambulatory phlebectomy.
Transilluminated powered phlebectomy typically does not take more than 1 hour to complete in an outpatient or office setting. The physician marks the patient’s leg veins with a special pen. After that, the legs are disinfected with an antiseptic and then anesthetized. The anesthetic used during transilluminated powered phlebectomy is a local anesthetic that is injected along the length of the veins to be removed. Regional or general anesthesia is also sometimes administered.
For each group of large varicose veins that needs to be removed with transilluminated powered phlebectomy, two small surgical incisions must be made. One incision serves as an entry point for a tiny light that illuminates the inner leg veins and makes it easier for the surgeon to see which veins to remove. The other incision serves as an entry point for a special suction device that removes damaged veins from surrounding tissue.
Transilluminated powered phlebectomy procedures need roughly 4 to 6 weeks of recovery time. Patients can continue with most daily activities during this time, but typically wear bandages for several days, followed by compression stockings for 1 to 2 weeks after the procedure. It may take a few weeks for bruising to fade.
If you’re interested in transilluminated powered phlebectomy as a form of varicose vein removal, please contact a vein doctor who performs the procedure.
Reviewed by Steven E. Zimmet, MD, RVT, FACPh
Editor of Phlebology
President, Zimmet Vein & Dermatology
Past-President, American College of Phlebology