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How does ambulatory phlebectomy work?

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Hi, I'm Dr. Steve Epstein. I'm a clinical specialist here at Vascular Epicenter. I'm board-certified in diagnostic and interventional, or invasive, radiology, and I've been in clinical practice for more than 20 years. How does ambulatory phlebectomy work? When the patient has very protuberant, or ropy, varicose veins that protrude beyond the surfaces of the skin, often, the heat ablation, or sclerotherapy, will not be sufficient to make those decompress or just vanish. When that happens, they can still remain symptomatic. Therefore, we sometimes have to just get them out, and that's what we do with ambulatory phlebectomy. Basically, we numb up the skin over these protuberant veins, or ropy veins, and pluck them out with a sterile crochet hook. It's very safe, it's painless. Small incisions, or stab incisions, are made at multiple levels, and we basically then tease out the vein and remove it, sort of like an inflamed appendix is removed by the surgeon. Sometimes, you just got to get it out of there.

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