When should one have microphlebectomy versus endovenous ablation procedures?

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?

Answers from doctors (8)


Vein Specialties of St. Louis

Published on May 15, 2018

These are separate procedures for different problems. EVLA is to seal the malfunctioning saphenous vein (long, short, accessor) from the inside. It is a deeper vein. Phlebectomy is used to remove the bulging varicose veins at the surface. I typically do both at the same setting so my patients only need to have one down time/off work, etc., and it is also more cost effective for them.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/623_1499902138.jpg
Answered by Vein Specialties of St. Louis

These are separate procedures for different problems. EVLA is to seal the malfunctioning saphenous vein (long, short, accessor) from the inside. It is a deeper vein. Phlebectomy is used to remove the bulging varicose veins at the surface. I typically do both at the same setting so my patients only need to have one down time/off work, etc., and it is also more cost effective for them.

Published on Jul 11, 2012


Vein Treatment Clinic

Published on May 14, 2018

When venous insufficiency is diagnosed in one of the superficial veins like the great saphenous vein and/or small saphenous vein, one procedure of choice that is used to target the vein is radiofrequency ablation. Ambulatory phlebectomy is a minimally invasive procedure also referred to as phlebectomy or microphlebectomy that is used to remove varicose veins directly underneath the skin in cases not related to saphenous vein reflux, or to treat those varicose and spider veins that remain even after treating underlying venous insufficiency with endovenous ablation.
I Hope this helps. Thank you for your question.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/8534_1510077584.jpg
Answered by Vein Treatment Clinic

When venous insufficiency is diagnosed in one of the superficial veins like the great saphenous vein and/or small saphenous vein, one procedure of choice that is used to target the vein is radiofrequency ablation. Ambulatory phlebectomy is a minimally invasive procedure also referred to as phlebectomy or microphlebectomy that is used to remove varicose veins directly underneath the skin in cases not related to saphenous vein reflux, or to treat those varicose and spider veins that remain even after treating underlying venous insufficiency with endovenous ablation.
I Hope this helps. Thank you for your question.

Published on Jul 11, 2012


Mid-Atlantic Institute of Venous and Lymphatic Medicine

Published on May 14, 2018

Endovenous ablation is commonly done along with micro-phlebectomy in the same setting or staged as an another procedure if there are too many bulging veins. There are some studies which showed doing micro-phlebectomy alone for the bulging veins can reverse venous reflux in the saphenous veins, and that is an option. If you go for this 2nd option, you would not need ablation and can be followed up to see if the venous reflux has resolved in the truncal veins.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/8625_1525274624.jpg
Answered by Mid-Atlantic Institute of Venous and Lymphatic Medicine

Endovenous ablation is commonly done along with micro-phlebectomy in the same setting or staged as an another procedure if there are too many bulging veins. There are some studies which showed doing micro-phlebectomy alone for the bulging veins can reverse venous reflux in the saphenous veins, and that is an option. If you go for this 2nd option, you would not need ablation and can be followed up to see if the venous reflux has resolved in the truncal veins.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Sep 05, 2010

Varicose veins are usually the result of malfunctioning valves in feeding veins. A venous ultrasound is necessary to find the malfunctioning valves. If there are refluxing (abnormal) valves then these are first treated with an ablation, then the varicose veins are treated by microphlebectomies. If no refluxing valves are present then the varicose veins can be treated without doing an ablation first.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1053_1499982262.jpg
Answered by Vanish Vein and Laser Center

Varicose veins are usually the result of malfunctioning valves in feeding veins. A venous ultrasound is necessary to find the malfunctioning valves. If there are refluxing (abnormal) valves then these are first treated with an ablation, then the varicose veins are treated by microphlebectomies. If no refluxing valves are present then the varicose veins can be treated without doing an ablation first.

Published on Jul 11, 2012


General Vascular Surgery Group

Published on Jan 15, 2010

Generally these are combined procedures in my practice. The ablation takes care of the feeder vein and the phlebectomies remove the surface veins.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/922_1408044082.jpg
Answered by General Vascular Surgery Group

Generally these are combined procedures in my practice. The ablation takes care of the feeder vein and the phlebectomies remove the surface veins.

Published on Jul 11, 2012


VeinSolutions - Edina

Published on Jan 14, 2010

We typically do both procedures together. The phlebectomies remove the bulging veins on the surface (alters the appearance of the leg) and the ablation closes the underlying vein that is causing the unsightly veins (the source of the problem).

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/861_1409954875.jpg
Answered by VeinSolutions - Edina

We typically do both procedures together. The phlebectomies remove the bulging veins on the surface (alters the appearance of the leg) and the ablation closes the underlying vein that is causing the unsightly veins (the source of the problem).

Published on Jul 11, 2012


VeinCare Centers of Tennessee

Published on Jan 14, 2010

Endovenous thermal ablation requires a relatively straight vein in order to pass the catheter or LASER fiber. Microphlebectomy is utilized for more tortuous varicose veins near the skin.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/755_1499906765.jpg
Answered by VeinCare Centers of Tennessee

Endovenous thermal ablation requires a relatively straight vein in order to pass the catheter or LASER fiber. Microphlebectomy is utilized for more tortuous varicose veins near the skin.

Published on Jul 11, 2012


Angelo N. Makris MD

Published on Jan 14, 2010

Microphlebectomy is usually done in conjunction with an ablation if there are large varicose veins.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/977_1408044083.jpg
Answered by Angelo N. Makris MD

Microphlebectomy is usually done in conjunction with an ablation if there are large varicose veins.

Published on Jul 11, 2012


Related Questions for Microphlebectomy

Microphlebectomy -8 answers
How long does it take one to recover after vein surgery?
See More
Microphlebectomy -5 answers
What is the length of recovery?
See More
Microphlebectomy -10 answers
I am 6 days post op from microphlebectomy. How long should I wear compression hose? Everyone seems to really vary with this answer...
See More
Microphlebectomy -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?
See More
Microphlebectomy -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?
See More
Microphlebectomy -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?
See More
Microphlebectomy -5 answers
How bruised will my legs be after the Microphlebectomy procedure?|
See More
Microphlebectomy -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?
See More
Get answers from our experienced doctors.
How it works
Microphlebectomy -10 answers
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?
See More
Microphlebectomy -5 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?
See More
Microphlebectomy -9 answers
Will I be put under? What is typically used for pain?
See More
Microphlebectomy -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?
See More
Microphlebectomy -5 answers
Do the incisions take longer to heal?
See More
Microphlebectomy -10 answers
It's been five weeks since my microphlebectomy on my leg and there are still many red bruise-type areas, that are very sensitive. Is this normal? And when will they disappear?
See More
Microphlebectomy -7 answers
I've heard microphlebectomy described as minimally invasive, but from what I understand it's still surgery. Wont there still be scars?
See More
Microphlebectomy -3 answers
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.
See More
Microphlebectomy -8 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?
See More
Microphlebectomy -11 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?
See More
Get answers from our experienced doctors.
How it works

Related Articles

Have specific questions?
ASK A DOCTOR