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.


How Vein Doctors Perform the Procedure

This is an outpatient procedure usually performed by a surgeon at a vein clinic, according to Radiology.org.  An ambulatory phlebectomy is particularly useful for removing veins that have developed near the surface of the skin.

After numbing the area, the surgeon makes an incision no bigger than a pencil eraser with a small scalpel or a needle.  Using a phlebectomy hook that resembles a tiny crochet hook, the physician removes the vein through the incision.  The incision is so small, it requires no stitches.

A majority of ambulatory phlebectomies require an hour or less.  However, if a patient has an extensive vein network that needs treatment, the best option might be a succession of procedures, the Virginia Commonwealth University Medical Center indicates.

The procedure begins with anesthesia and cleaning the skin in the surgical area prior to making an incision.  Patients usually report feeling no pain during the phlebectomy.

Once the surgeon extracts a vein, the surgical staff places a compression bandage or wrap on the area.  Most patients can return to their normal daily schedules the day after surgery.  Before discharge, they receive a detailed list of instructions for home care, strenuous activities to avoid, and return visits.  It is usually necessary to wear compression stockings for about 14 days.

Since it requires no stitches, an ambulatory phlebectomy has advantages over some older varicose vein treatments.  It also enjoys a success rate exceeding 90 percent.

The primary risk factor is development of an infection after an incision.  However, the odds of developing one for which antibiotics are necessary are less than 1 in 1,000.  Any pigmentation that develops at the site is normally temporary, and most patients see no evidence of the treatment two months afterward.

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