Ambulatory Phlebectomy for Varicose Veins

By: Dr. Mark Becker

Ambulatory phlebectomy is a process used for treating varicose veins.

The procedure, performed on an outpatient basis, involves a series of tiny incisions, punctures, or slits through which the varicose veins are removed. The slits are so small that no stitches are required.

The four steps involved are:

  1. Marking the veins to be treated
  2. Injecting a local anesthetic to the treatment area
  3. Making small incisions and removing the bulging veins
  4. Recovery, during which you will need to wear compression stockings for a week or so

What should I consider before having an ambulatory phlebectomy?

Before you undergo this procedure, your doctor may want to evaluate your veins, which may involve a physical exam and patient history, as well as ultrasound examination and/or Doppler.

This evaluation will tell the doctor:

  • If the varicose veins are the primary concern or if there are other veins to be treated first
  • If there are more serious underlying issues, such as clots in other veins
  • Any other procedures that may be needed in addition to the ambulatory phlebectomy

What is ambulatory phlebectomy used for?

The large, bulging superficial varicose veins are usually the primary target for this procedure, although smaller veins may be treated as well.

Who should not have ambulatory phlebectomy?

If you are allergic to the local anesthetic, can’t walk without assistance, or can’t wear compression stockings because of circulation problems, you should not have ambulatory phlebectomy. If you have any sores, rashes, or infections in the treatment areas, you will have to wait until they heal before this procedure.

Does ambulatory phlebectomy hurt?

The local anesthetic should prevent you from feeling anything during the procedure, and most patients report no major discomfort afterward, especially those who wear compression stockings in the week following treatment.

Are there side effects or complications from ambulatory phlebectomy?

  • After the procedure, you may experience mild bruising and swelling in the treated area, which can be alleviated with over-the-counter pain relievers and by wearing compression stockings as directed.
  • The small incisions will heal on their own without stitches and will be virtually unnoticeable within six months to a year (in darker skin, the incisions may darken before fading).
  • On rare occasions, a small segment of the varicose vein may remain in the skin, becoming swollen and tender (thrombophlebitis). This will usually resolve on its own with over-the-counter medications and compression stockings.
  • If a sensory nerve is injured during the procedure (an uncommon occurrence), you may experience numbness in that area.

After the surgery, you should be able to walk and perform normal everyday activities, but avoid rigorous exercise or heavy lifting until your doctor says it is okay to do so.