Is Ambulatory Phlebectomy A Good Choice For You?

For millennia, people have suffered from varicose veins; vein doctors and vascular surgeons have tried various strategies to treat them. In the modern world, you have a number of options. You may receive treatment in a vein clinic, vein treatment center or doctor’s office. Treatment options today include minimally invasive procedures rather than major surgery, as was common in years gone by. Here’s some information about one of those options – ambulatory phlebectomy – from the Bridgeport Vein Center in Portland, Oregon.

How Varicose Veins Develop

Blood in the arteries is circulated through the force of pressure from the heartbeats, but the veins need a little help. Muscle contractions in the legs push blood up to the heart and the veins have tiny flaps of tissue called valves that help prevent the blood from running backward. If these valves stop working properly – which often occurs as you get older – the blood will pool in the leg veins. Varicose veins are often distended and twisted – very visible in shorts, short skirts or swimwear.

Choosing Ambulatory Phlebectomy

Ambulatory phlebectomy was actually not developed by a vein doctor, but by a Swiss dermatologist named Robert Muller. Minimally invasive, the procedure typically takes about an hour – plus some time before and after for preparation and recovery. It is used for the smaller surface varicose veins which are most visible. Ambulatory phlebectomy is an option for nearly all patients, except those who cannot walk on their own or cannot wear compression stockings.

Ambulatory Phlebectomy: Preparation and Procedure

Preparation for this procedure is simple – schedule the procedure, come to the office and don’t shave your legs the day of the procedure. After the injection of local anesthetic, the doctor inserts a tiny hook through a very small incision (cut) in the skin. The hook is used to pull up the vein, which is then grasped with a special tool and gently pulled out of the leg. After dressings and compression stockings are in place – no stitches needed in most cases – the patient is ready to go home.

Ambulatory Phlebectomy: Aftercare

As soon as the compression stockings are in place, you can get up and walk around. You’ll be able to go home almost immediately, and in most cases, you can resume your normal activities within a day or so. It’s a good idea to avoid strenuous exercise for about a week after the procedure, although vein doctors have different routines, so follow your doctor’s instructions. Temporary bruising or swelling may be present and sometimes the puncture sites will ooze a little. Take recommended pain medications if needed and wear the compression stockings as instructed – usually for two to three weeks.

If you are considering varicose vein treatment, please contact the Bridgeport Vein Center. Dr. Kenneth A. Janoff, MD, FACS, and the team can answer your questions to help you decide on the best treatment strategies. We serve the Portland and Lake Oswego areas of Oregon.

How to Get Ready for Ambulatory Phlebectomy

If you have varicose veins, you have a number of options for treating them. For example, ambulatory phlebectomy is a minimally invasive, effective treatment. Although it doesn’t require general anesthesia and typically has a limited recovery time, getting ready for it in advance is still a good idea. Here are a few things worth doing before you head to the vein clinic for varicose vein treatment.

Ambulatory Phlebectomy Preparation

Stock Up

It’s common for vein doctors to recommend wearing compression stockings after ambulatory phlebectomy. Compression stockings help improve your results from the procedure. Since it’s important that the stockings you get fit you and do a good job of compressing your legs, it’s a good idea to purchase them before your procedure. Buying your stockings in advance also means you’ll have the ready to go on the day of your treatment.

Confirm Medications

Your vein doctor might ask you to take certain medications before your phlebectomy and he might ask you to stop taking certain medicines several days before the treatment. For example, it’s usually recommended that you avoid taking vitamin E supplements or aspirin a few days before the treatment, as both can thin your blood and increase your risk for bruising, bleeding and other complications.

If you are taking any other types of medicine, it’s a good idea to check in with the vascular surgeon to make sure they are safe to continue taking. Your doctor might also recommend that you take certain medications, such as certain pain relievers or a muscle relaxer, to make the procedure more comfortable and to reduce any pain afterwards.

Plan Your Outfit

It might sound frivolous, but you want to think carefully about what you wear on the day of your treat. Loose fitting clothing is usually ideal. You’ll be the most comfortable in it. It’s also a good idea to wear shorts or a skirt that exposes your legs.

Have a Good Breakfast or Lunch

One of the great things about ambulatory phlebectomy is that it doesn’t require general anesthesia. That means you don’t have to fast the morning of or the night before.

In fact, depending on when your procedure is scheduled, it’s often a good idea to make sure you enjoy a decent breakfast or lunch beforehand. You don’t want to become hungry in the middle of the treatment and you don’t want to be frantically trying to get a meal right afterwards.

Be Ready to Rest Afterwards

Although the treatment is minimally invasive, it’s a good idea to leave some room in your schedule to rest up after it. Don’t schedule workouts or major activities during the first few days or week after your treatment, for example.

If you are ready to learn more about your varicose vein treatment options and what to do to prepare, contact Bridgeport Vein Center for more information today.


Choosing the Right Doctor and Vein Clinic for Your Ambulatory Phlebectomy

Why Get an Ambulatory Phlebectomy?

An ambulatory phlebectomy is a surgery that removes surface veins, and can work well for people who are suffering from varicose or spider vein problems. Because it is a small surgery there is usually no need for stitches, and the procedure can be performed under general anesthesia at an outpatient clinic. When you choose a vein doctor for your ambulatory phlebectomy or any vein procedure, however, you want to make sure the doctor and the procedure are the right ones for you. Then you can have the highest chance of the best possible outcome for your situation and get back to having healthy veins.

All Vein Doctors are Not the Same

While there are many vascular surgeons who offer the same services, that doesn’t mean they have the same bedside manner, pricing, or experience. It is generally a good idea to seek a second opinion for serious surgical procedures, although you may not want or need to do that for something minimally invasive. Still, you want to feel comfortable with the vein doctor you choose. Consider the years of schooling and experience that doctor has, and the number of reviews you can find online. Look for any disciplinary actions, and ask to see before and after photos of the work that was done for prior patients.

Additionally, remember that vast amounts of experience in helping improve people’s veins may not mean much if most of that involves other procedures. There is nothing wrong with questioning how much experience a vein doctor has with the specific procedure you will be undergoing. The more experience the doctor has performing that procedure, and the larger the number of satisfied patients, the more likely it is that you will also have a good experience with your ambulatory phlebectomy. By talking to your doctor to get the information you need about the procedure, you can determine your level of comfort.

Choose a Quality Vein Treatment Center

The doctor who is performing your procedure is very important, but you also want to make sure the treatment center is one you feel good about. You may spend some time there if you need more than one treatment, and there will be pre-op and post-op care, as well. Choosing a place where you feel comfortable matters, as does selecting a clinic that offers kind people, good treatment, and an answer to your questions. You shouldn’t feel afraid to ask the doctor or the staff for information about the procedure, the clinic, and any potential issues that could arise from your procedure. When it comes to medical treatment, the more knowledge you have the easier it is for you to make the right choice about the care you will receive.

Vein Doctor Recommends an Ambulatory Phlebectomy

For some patients, varicose veins are more than unsightly blood vessels on their legs or feet.  They can cause significant discomfort and lead to rare but serious complications like painful ulcers. Fortunately, a vein doctor can offer a number of treatment options.  One procedure that vein doctors, also known as vascular surgeons, sometimes advise is an ambulatory phlebectomy.

What Exactly is an Ambulatory Phlebectomy?  phlebectomy

Varicose vessels form because of faulty valves in veins, which return blood from the lower extremities to the heart.  When a valve stops functioning due to age or damage, blood cannot flood upward and pools behind it.  The result is a varicose vein.

The Virginia Commonwealth University (VCU) Medical Center indicates that an ambulatory phlebectomy is a minimally invasive procedure performed at a vein clinic to treat varicose vessels that lie just under the skin.  Using a small tool called a phlebectomy hook, the surgeon makes one or more tiny incisions and extracts the targeted veins.  According to UCLA Health, because veins collapse easily, it is possible to remove even large vessels through these small incisions.

Complications with this treatment are very rare.  They might include blistering, infection, bruising, loss of sensation, or visible scars.  However, most of these resolve without any problems over the long term.

What to Expect at the Vein Treatment Center

Vascular surgeons perform this procedure when the patient has been anesthetized.  While some physicians prefer a general anesthetic, others routinely rely on local anesthesia.

When an extended network of varicose vessels has developed in a limb, patients typically need to appear two or three times for treatment by vein doctors.  A treatment session usually takes no more than two hours and sometimes much less.  Individuals report little discomfort after the procedure.

A few days after treatment, bandages come off the affected areas.  Patients wear compression stockings for several weeks until healing is complete and are able to resume most normal activities right away.

Incisions used in this treatment are so small that they usually require no stitches to heal and leave very faint puncture marks.  VCU indicates that the incisions are practically invisible two months after surgery.  After six months, there is usually no sign of the procedure.

When forming expectations about an ambulatory phlebotomy, patients should realize that removing all targeted varicose veins does not guarantee that no more will appear.  Most individuals require annual follow-up venous circulation checks to make sure no additional treatment is necessary.

When conservative measures such as losing weight or elevating the legs do not bring relief, vascular surgeons can offer options in addition to ambulatory phlebectomies.  Other types of treatment for varicose veins include sclerotherapy, laser surgery, procedures that are catheter-assisted, endoscopic surgery, and vein stripping, according to the Mayo Clinic.

When Ambulatory Phlebectomy is the Right Choice

Patients with varicose veins sometimes face both cosmetic and medical issues.  Fortunately, over the last two decades, their options for vein treatment have multiplied.  Newer treatments are less invasive than procedures like vein stripping and require shorter recovery times.  The result is quicker alleviation of pain and a faster boost in self-confidence.  One of the current treatment methods is an ambulatory phlebectomy.

Overview of Varicose Vein Options and Ambulatory Phlebectomy

The path to getting rid of varicose veins begins with a consultation with a specialist.  These doctors are typically vascular surgeons.  At the consultation, the physician takes a medical history, conducts a physical exam, and recommends treatment options.

For many individuals, treatment begins with conservative steps like weight loss, elevating the affected leg, or wearing compression stockings.  The Mayo Clinic reports that the most frequently used ways to treat more severe varicose veins include:

  • Sclerotherapy for small to medium veins
  • Laser surgery
  • Endoscopic surgery
  • Catheter-assisted heat
  • Ambulatory phlebectomy
  • Vein stripping

For some patients, a combination is effective.


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