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Is microphlebectomy effective in treating varicose veins?

I’ve heard microphlebectomy is a newer surgical treatment method for varicose veins. What exactly is it, and is it as effective as other surgical or minimally-invasive treatment options?

The information provided by medical professionals in the Q&A is for informational purposes only, and is not a substitute for individualized medical advice, diagnosis or treatment by a qualified health care provider.

Answers


Replied on 9/15/2010

By: Vanish Vein and Laser Center  |  Dr. John Landi, FACS, RPVI, RPhS
Medical Director, Diplomate Am. Board of Phlebology

Naples, FL


Microphlebectomy is excellent for removing varicose veins of all sizes. It is performed under local or tumescent anesthesia usually in the office setting and patients can resume normal activities other than swimming or strenuous activities within 24 hours. Tiny 2-3 millimeter incisions are made and the veins are hooked out. Prior to this, however, a venous reflux exam should be done to identify the source of the varicose veins.


Replied on 10/6/2009

By: VeinSolutions - Edina  |  
Edina, MN


Phlebectomies are not a new procedure for treating varicose veins. They are effective for removing the bulging veins you can see on the surface of your leg. Most patients will also need a VNUS Closure or vein stripping in order to close down or remove the vein that is the
underlying source of the varicose veins. Phlebectomies are performed by making a tiny stab at the site of the vein and pulling the vein out. The incisions are small enough that no sutures are needed.


Replied on 10/6/2009

By: Angelo N. Makris MD   |  Angelo N. Makris, M.D. Interventional Radiology Center
Oak Brook, IL


Microphlebectomy is a minimally invasive procedure in which varicose veins are removed though small (2-3mm) nicks in the skin. Most of the time it is performed in conjuction with an ablation. This is because varicose veins are similar to a tree with branches. The varicose veins that are visible are branches off of a vein trunk that is not visible. An ablation treats the trunk of the tree and the microphlebectemy treats the branches.


Replied on 10/6/2009

By: The Kimmel Institute  |  Dr. Richard Kimmel
Boca Raton, FL


Microphlebectomy is indicated for medium to large tortuous veins that may not be amenable to treatment with endovenous laser or chemical ablation. It is safe and highly effective, with minimal cosmetic drawbacks.

The treatment involves local anesthesia and tumescent anesthesia, done in the office setting, and using tiny (1-2mm) incisions, the vein is teased out and removed. A surgical hook type instrument (like a crochet hook) is used to grasp the vein and then it is pulled out through the small incision. Stitches are not needed. The limb is wrapped with a compression stocking and ACE bandage, and the patient can resume normal (non-strenuous) activity the same day.


Replied on 10/6/2009

By: Vein Center Houston  |  Mario O. Kapusta, M.D., RVS, RPVI, ABPh
Houston, TX


Microphlebectomy is highly effective in the treatment of Varicose Veins. In general, after closing the vein responsible for reflux, microphlebectomy is used to remove remaining veins. Once removed, those veins do not return. Microphlebectomy is minimally invasive. The skin is opened with a needle and a hook is used for gentle removal of the varicose veins.


Replied on 10/5/2009

By: Heart and Vein Center  |  Rodolfo D. Farhy, MD, FACC, FAHA
Lathrup Village, MI


Microphlebectomy is an effective method to treat varicose veins. The results varies depending the patient's anatomy and extent of the disease. Although microphlebectomy can be done asisolated procedure, most of the times it is used in combination with other procedures like endovenous laser treatment (EVLT) and/or ultrasound guided sclerotherapy.



Replied on 10/5/2009

By: VeinCare Centers of Tennessee  |  Stephen F. Daugherty, M.D.,F.A.C.S.
Clarksville, TN


The term phlebectomy refers to removal of veins. The old phlebectomies performed in the operating room under general anesthesia usually were performed with incisions one to several cm long under general anesthesia. The relatively crude techniques of removing the veins through the large incisions and the need to suture the incisions closed resulted in
significant bleeding into the tissues which was associated with considerable post-op pain. Wound healing sometimes was a significant problem as well.

Microphlebectomy refers to phlebectomy through incisions which usually are 2 to 3 mm long. The varicose veins are removed through the small incisions with small steel hooks which are passed through the incisions. Blood loss usually is much less than a teaspoonful and there usually is little bleeding into the tissues. No sutures are needed for th small incisions. Post-operartive pain for most patients is very minimal. Most patients need
only drugs such as ibuprofen or Aleve after the procedures.

Many patients receive a mild oral painkiller or sedative prior to the procedure to reduce the discomfort from injecting the local anesthetic for the procedure. The large volume of very dilute anesthetic agent is injected into the fatty tissue around the varicose veins. The drug compresses the veins and a drug in the anesthetic also constricts the veins thus allowing
removal of very large veins through tiny incisions with minimal blood loss.

Microphlebectomy is utilized for tortuous varicose veins near the surface of the skin which are judged by the treating physician to be too large for sclerotherapy.

Microphelbectomy removes the vein permanently which some patients prefer over sclerotherapy which leaves behind a vein which may reopen over time. it does leave benind very tiny scars which usually are not very noticeable by six months after the procedure. Since it is done in the office setting with local anesthesia, it is far more cost effective and safer th


Replied on 10/5/2009

By: General Vascular Surgery Group  |  Michael D. Ingegno, M.D.
Robert O’Neil Gingery, M.D.
Lamont D. Paxton, M.D.

San Ramon, CA


Generally microphlebectomy is a complementary treatment to catheter ablation treatments for varicose veins. It is not a new treatment and variations on this treatment have been around for many years. These days however, the treatment is generally done with minimal puncture incisions, for much less scarring. Catheter ablation (laser or Radio frequency) is the newer treatment to replace vein stripping, to treat the larger feeder veins. This is an
office procedure with minimal downtime and excellent results.


Replied on 10/5/2009

By: Vein Specialists  |  Joseph G. Magnant, M.D., F.A.C.S.
Fort Myers, FL


Microphlebectomy is not a new procedure and in fact has been around since the 1950s, and long before that in ancient times as well. Micro means small, phleb is latin for vein and ectomy is the suffix which means to remove.micro-phleb-ectomy. It is effective in treating tortuous varicose veins which are too large to be injected and too superficial and tortuous to
be treated with modern endovenous sealing techniques. Endovenous ablation or closure either with Radiofrequency or laser energy is the "newest" treatment and has been around for the past 10 years but has only really gained momentum as the preferred method of treatment of vein disorders in the last 5-7 years.



More Questions on Microphlebectomy

Is microphlebectomy the same thing as ambulatory phlebectomy? (12 answers)
I have large varicose veins on both legs and am trying to figure out what the best treatment is. Microphlebectomy and ambulatory phlebectomy both are surgical procedures, and they sound kind of the same. Which is better?

Can the blue tint in my leg still be a vein after microphlectomy? (12 answers)
A part that was left in my leg after microphlectomy looks blue but concave. Could the remainder of the space where the vein was taken out be a blue tint? I am paranoid there is still vein left.

How long do I have to wear compression hose after microphlebectomy? (11 answers)
I am 6 days post op from microphlebectomy. How long should I wear compression hose? Everyone seems to really vary with this answer...

What is the recovery time after cauterizing veins with microphlebectomy? (11 answers)
How long does it take one to recover after vein surgery?

Does microphlebectomy cause scarring? (10 answers)
I've heard microphlebectomy described as minimally invasive, but from what I understand it's still surgery. Wont there still be scars?

When would microphlebectomy be used instead of ELA? (9 answers)
It seems like ELA is less invasive.

Should I get Microphlebectomy and Endovenous Ablation to ensure my varicose veins do not come back? (9 answers)
I have multiple large superficial veins on my legs. Should I get microphlebectomy to get rid of the veins themselves, and then ELA so they don't come back? Or will ELA be enough that I wont need microphlebectomy?

Is there any risk in not doing microphlebectomy after the closure procedure? (9 answers)
My leg feels a lot better after 2 months (not perfect) but some bulging veins remain. Could I worsen my condition if I don't remove the bulging veins? How would blood flow out?

Is microphlebectomy safe for removing varicose veins near the inner ankle bone and foot? (9 answers)


Can the same results be achieved if a microphlebectomy is done before endovenous laser ablation? (8 answers)
My doctor didn't notice the saphenous vein was abnormal until right before the microphlebectomy was to be done. He suggested that we could do the endovenous laser ablation later on. Will the same results be achieved if the microphlebectomy was done first?

Does microphlebectomy require a longer recovery time than endovenous ablation techniques? (8 answers)
Do the incisions take longer to heal?

When should one have microphlebectomy versus endovenous ablation procedures? (8 answers)
I want to have my varicose veins on my legs addressed. Are there certain circumstances where microphlebectomy is better than endovenous ablation? Or vice versa?

Will I need to take antibiotics after my Microphlebectomy procedure? (8 answers)
Is the risk of infection very high?

How long before Microphlebectomy should I stop taking aspirin? (8 answers)
I’ve heard that taking aspirin could complicate the procedure. I take aspirin daily, but I want to make sure it doesn’t affect my vein procedure. What is a safe period of time to allow for the drug to be out of my body?

What kind of anesthesia is used during Microphlebectomy? (8 answers)
Will I be put under? What is typically used for pain?

How does Microphlebectomy work? (7 answers)
How can the large veins be pulled out of such small little incisions?

What kind of Varicose veins are best treated with Microphlebectomy? (7 answers)
I have some smaller, superficial varicose veins (they aren't as small as spider veins), and also two larger, more ropy varicose veins, all on the same leg. Can microphlebectomy treat both types of veins, or should I look into ablation procedures?

What is the recovery and post-operative care like after microphlebectomy? (7 answers)
What is the length of recovery?

Does no compression hose after small microphlebectomy sound right? (7 answers)
I have 2 small reticular veins that are varicose. My doctor is going to do a Microphlebectomy. He said due to the size it won't even be necessary to wear compression hose after. He also stated there is no chance of DVT. Does this sound accurate?

Why am I experience pain in my pelvic/vaginal area after a VNUS closure and phlebectomy? (7 answers)
I had a VNUS closure with phlebectomy on my right leg (near the knee and calf region). This was 10 days ago and I am still experiencing low pelvic pain and vaginal discomfort more each day. Why is this happening?

Is numbness after microphlebectomy normal? (7 answers)
Ten days after microphlebectomy I still have numbness and tingling on the top and medial aspect of my right foot and ankle. What is this from and will it resolve?

How long after laser ablation and microphlebectomy can I swim, shave and use self-tanner? (5 answers)
I had a laser ablation and microphlebectomy for a large varicosity from the inner thigh to the lower shin. When will I be able to shave my legs, go swimming and use lotion with a tanning agent?

Pain 5 weeks after phlebectomy? (5 answers)
I had some phlebectomy's 5 weeks ago (2 at the ankle, 1 over the knee, 1 medial superior calf). I have burning pain & tenderness over some of the remaining posterior veins in the calf. DVT was ruled out. How long does phlebitis last? is this normal?

Can I expect a lot of bruising after Microphlebectomy? (5 answers)
How bruised will my legs be after the Microphlebectomy procedure?|

PE after microphlebectomy (4 answers)
I've have PE after this procedure. I'm currently on Dabigatran 150 mg 2/day for 3 months. I never had DVT before and I'm very active . I'm very nervous how long I'm in danger of another PE related to the same proc.

Under eye veins (4 answers)
Is there any danger to having veins under the eyes removed? Should this procedure be avoided if the patient has circulatory problems? How wide are the incisions for removing under eye veins? What is the cost of this procedure typically?

Yellow fluid is draining from one of the incisions made during microphlebectomy, is this normal? (4 answers)
I had a microphlebectomy a week ago. The doctor inserted a lot of fluid in the veins to deaden them. I am now having a lot of drainage from one of the cuts. It is yellow in color. Is this normal, or is it something I should be concerned about?

I have small pieces of tissue coming from the microphlebectomy incision sites, should I be trimming it? What to do about pain? (4 answers)
I have small pieces of tissue coming from several incision sites. I can pull them and trim some, but then they bleed a little. Should I be trimming this tissue? Also, what about the incision site on top of my foot that hurts a lot and sends shooting pain down my foot?

How do I get rid of the bulging veins on the side of my forehead? Is microphlebectomy an option? (3 answers)


About how long after a Microphlebectomy does it take the remaining vein to clot (go away)? (3 answers)
Can you give me a approximate time for the remaining vein to clot?

Why would my doctor recommend both RF and microphlectomy? (2 answers)
I am a big built, 6'2 healthy man. My right leg has large looking veins and after having an analysis, it was recommended that I have RF, followed by microphlebectomy. Is microphlebectomy really necessary? If so, why?

Should I put an ointment on the incision site after a microphlebectomy? (1 answer)
I just had a microphlebectomy on my left leg yesterday and my leg is pretty sore, especially on my knee where he took out a vein. I still have gauze on them but was wondering if I should put bacterium or neosporin ointment on all the little cuts.

No compression hose after small microphlebectomy (1 answer)
I have 2 small reticular veins that are varicose. My doctor is going to do a Microphlebectomy. He said due to the size it won't even be necessary to wear compression hose after. He also stated there is no chance of DVT. Does this sound accurate?

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