Ambulatory Phlebectomy

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This procedure is done to remove varicose veins on the surface of the leg. Phlebectomy is a minimally invasive procedure and is performed by making tiny incisions in the leg. Because veins are very collapsible, the enlarged varicose veins can be removed through these small incisions. When performed for the appropriate medical reasons, phlebectomy has a 90% long-term success rate in treating varicose veins.

Need to Know

Nice to Know
  • Don’t take aspirin or Vitamin E at least 5 days before
  • Don’t eat or drink at least 8 hours before
  • If you have diabetes, ask your primary care doctor about adjusting your insulin dose
  • Inform your technologist if you are pregnant
  • Wear comfortable, loose-fitting clothing
  • You’ll be given a gown to wear during your treatment
  • You’ll be awake during the procedure and can go home after
  • No surgical incision is needed, just a small nick in the skin
  • You may feel some discomfort after the procedure, but no serious pain
  • You will be required to wear compression stockings for about two weeks following the procedure
  • Most patients can resume regular activities immediately following the procedure if the compression stockings are worn
  • Strenuous activities can typically be resumed within two weeks following the procedure

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How Does It Work?

Your physician will make a series of tiny incisions in your leg in the area that surrounds the varicose veins. Then, using a phlebectomy hook -- a tiny instrument that resembles a crochet hook with a blunt tip and a straight shaft – the physician will remove the veins.

What Happens — Before, During, and After?

When you arrive for your procedure a nurse will greet you and let the team know you’ve arrived. You will be brought into an exam room and asked to change into a gown. Your doctor will greet you, explain the procedure and answer any questions you may have.

You will lie on an exam table for the procedure. After cleaning the area of the skin, your physician will numb the area with a local anesthetic. You will feel a tiny pinch from the anesthesia.

Once the area is numb, your physician will make a series of incisions no larger than a pencil eraser in the area of the enlarged veins. A phlebectomy hook is inserted under the surface of the skin to remove the varicose vein through the tiny incisions. Patients rarely report any pain or discomfort during the procedure but you may feel the pressure of the phlebectomy hook being inserted and removed. The incisions are so tiny that no stitches are necessary. This procedure is usually completed between 45 minutes and one hour.

When your physician has completed the procedure, your leg will be wrapped in a compression wrap. This wrap will feel snug but most patients report that it is comfortable. In most cases, patients do not report pain or discomfort following the procedure.

You will be sent home as soon as you feel ready. Your doctor will give you instructions about wearing the compression stockings and explain to you what activities, if any, are limited.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. For example, you may want to arrange to have someone drop you off and pick you up. You might like to keep a list of questions or — as you’re doing now — educate yourself about the procedure.

Another important part of your preparation will be guided by your doctor:

  • Wear loose, comfortable clothing to the procedure
  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin or warfarin) for a time before the procedure.
  • The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a nurse from your doctor’s office will call you. The nurse will give you any additional instructions, and will ask if you have any questions.
  • When you arrive, make sure the nurse and radiologist know about any allergies you may have, especially allergies to local anesthetics, such as lidocaine. If there’s any chance you may be pregnant, tell your physician.
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What Should I Bring?

  • Comfortable, loose-fitting clothes
  • Comfortable shoes
  • Avoid bringing jewelry or valuables
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What Are the Benefits and Risks?

The benefits of minimally invasive abscess drainage could be:

  • High chances of success in treating your varicose veins. Success rates of 90% and higher have been reported with this procedure worldwide
  • No surgery is required and only small nicks in the skin are made. These do not require stitches
  • Most patients do not report any pain or discomfort during and after the procedure

Risks you should be aware of include:

  • As with any procedure, there is a small risk of infection. The chance of infection requiring antibiotic treatment is less than one in 1,000.
  • In some cases, skin discoloration at the site of the treated varicose vein may occur but is usually temporary

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.

 

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