I have large ropey veins in the back of my knee following endovenous laser ablation, should I try sclerotherapy or microphlebectomy?

Answers from doctors (11)


More About Doctor David Green, MD

Published on Mar 02, 2022

Sclerotherapy can effectively and more completely remove varicose veins than microphlebectomy. If done properly, sclerotherapy results in the solution entering all segments of the varicose veins. Microphlebectomy only incompletely removes segments of varicose veins often resulting in persistence because of connections to other veins.

Also, Sclerotherapy does not leave scars. Microphlebectomy almost always leaves small scars that are visible to everyone except for the surgeon performing the procedure.

Answered by David Green, MD (View Profile)

Sclerotherapy can effectively and more completely remove varicose veins than microphlebectomy. If done properly, sclerotherapy results in the solution entering all segments of the varicose veins. Microphlebectomy only incompletely removes segments of varicose veins often resulting in persistence because of connections to other veins.

Also, Sclerotherapy does not leave scars. Microphlebectomy almost always leaves small scars that are visible to everyone except for the surgeon performing the procedure.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on May 21, 2013

Sclerotherapy, or more specifically ultrasound-guided sclerotherapy, would be my choice. Microphlebectomy is a form of stripping and can leave permanent scars that you may not like. However, I would look for someone who is skilled in the use of ultrasound in sclerotherapy. Not all self-proclaimed vein doctors are created equal.

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Answered by The Sheen Vein Institute

Sclerotherapy, or more specifically ultrasound-guided sclerotherapy, would be my choice. Microphlebectomy is a form of stripping and can leave permanent scars that you may not like. However, I would look for someone who is skilled in the use of ultrasound in sclerotherapy. Not all self-proclaimed vein doctors are created equal.

Published on Jul 11, 2012


Intermountain Vein Center

Published on May 20, 2013

Usually the interventional radiologist would recommend the microphlebectomy to remove those veins in conjunction with sclerotherapy. Those procedures are almost always done together for a better medical and cosmetic result.

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Answered by Intermountain Vein Center

Usually the interventional radiologist would recommend the microphlebectomy to remove those veins in conjunction with sclerotherapy. Those procedures are almost always done together for a better medical and cosmetic result.

Published on Jul 11, 2012


Heart and Vein Center

Published on May 16, 2013

Your vein doctor should be the recommending the best treatment option. If the vein is really large, then microphlebectomy would be the best option.

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Answered by Heart and Vein Center

Your vein doctor should be the recommending the best treatment option. If the vein is really large, then microphlebectomy would be the best option.

Published on Jul 11, 2012


Vein Center of Orange County

Published on May 16, 2013

First, make sure the ultrasound shows the vein targeted by laser ablation is closed. If it is closed, both sclerotherapy and phlebectomy are good choices for remaining surface varicosities. Phlebectomy eliminates the vein more quickly at a higher cost, but there will be small scars. On the other hand, sclerotherapy costs less and leaves the patient scar-free, but takes longer for the vein to disappear.

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Answered by Vein Center of Orange County

First, make sure the ultrasound shows the vein targeted by laser ablation is closed. If it is closed, both sclerotherapy and phlebectomy are good choices for remaining surface varicosities. Phlebectomy eliminates the vein more quickly at a higher cost, but there will be small scars. On the other hand, sclerotherapy costs less and leaves the patient scar-free, but takes longer for the vein to disappear.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on May 16, 2013

Microphlebectomy would best solve this problem.

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Answered by Cosmetic Vein Centers of Texas

Microphlebectomy would best solve this problem.

Published on Jul 11, 2012


Arizona Vein Specialists

Published on May 15, 2013

Microphlebectomy is more cosmetic in terms of results; however, both techniques can be considered. Obviously, without seeing your leg, I cannot be any more specific. You should consult with an experienced surgeon who is qualified to perform both procedures and who can guide you on which treatment is best.

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Answered by Arizona Vein Specialists

Microphlebectomy is more cosmetic in terms of results; however, both techniques can be considered. Obviously, without seeing your leg, I cannot be any more specific. You should consult with an experienced surgeon who is qualified to perform both procedures and who can guide you on which treatment is best.

Published on Jul 11, 2012


Advanced Vein Center

Published on May 15, 2013

Both ultrasound-guided foam sclerotherapy and microphlebectomy are effective alternatives to treat medium to large residual refluxing tributaries after endovenous laser ablation of affected truncal veins. I find sclerotherapy to be less uncomfortable and it treats vessels that may not be apparent at the skin surface but are the cause of significant symptoms. I prefer this alternative. However, this presumes the person treating you has experience with ultrasound-guidance foam sclerotherapy. This is an important consideration. Likewise, if you select microphlebectomy, it is important that the person performing the procedure have adequate expertise with this technique.

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Answered by Advanced Vein Center

Both ultrasound-guided foam sclerotherapy and microphlebectomy are effective alternatives to treat medium to large residual refluxing tributaries after endovenous laser ablation of affected truncal veins. I find sclerotherapy to be less uncomfortable and it treats vessels that may not be apparent at the skin surface but are the cause of significant symptoms. I prefer this alternative. However, this presumes the person treating you has experience with ultrasound-guidance foam sclerotherapy. This is an important consideration. Likewise, if you select microphlebectomy, it is important that the person performing the procedure have adequate expertise with this technique.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on May 15, 2013

Both sclerotherapy and microphlebectomy could help resolve the large ropey veins in the back of your knee. Sclerotherapy requires more treatments, but the treatments are simpler and easier.

Answered by Laser Vein Center (View Profile)

Both sclerotherapy and microphlebectomy could help resolve the large ropey veins in the back of your knee. Sclerotherapy requires more treatments, but the treatments are simpler and easier.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on May 15, 2013

I normally remove ropey veins at the time of ablation so that my patients no longer need any further procedures. I prefer microphlebectomy for larger varicosities. It gives a nice, cosmetic result in one treatment. Sclerotherapy works well on smaller varicosities or reticular veins, but usually involves several treatments. These may or may not be covered by insurance. On the other hand, microphlebectomy typically is.

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Answered by Vein Specialties of St. Louis

I normally remove ropey veins at the time of ablation so that my patients no longer need any further procedures. I prefer microphlebectomy for larger varicosities. It gives a nice, cosmetic result in one treatment. Sclerotherapy works well on smaller varicosities or reticular veins, but usually involves several treatments. These may or may not be covered by insurance. On the other hand, microphlebectomy typically is.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on May 15, 2013

Microphlebectomy would be the better choice since one procedure will eliminate the problem. If you should do sclerotherapy, then you may require multiple sessions and the resulting clotted veins will take a long time to resolve.

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Answered by Vanish Vein and Laser Center

Microphlebectomy would be the better choice since one procedure will eliminate the problem. If you should do sclerotherapy, then you may require multiple sessions and the resulting clotted veins will take a long time to resolve.

Published on Jul 11, 2012


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