When would microphlebectomy be used instead of ELA?

It seems like ELA is less invasive.

Answers from doctors (6)


More About Doctor David Green, MD

Published on Aug 31, 2021

An alternative to Microphlebectomy is Sclerotherapy. I find Sclerotherapy to be more effective with a greater chance of removing all veins within a cluster without any incisions.

Endovenous Ablation (laser or radiofrequency) is primarily used to treat Great or Small Saphenous Vein insufficiency. It has replaced vein stripping. Microphlebectomy is not an alternative to Endovenous Ablation.

Answered by David Green, MD (View Profile)

An alternative to Microphlebectomy is Sclerotherapy. I find Sclerotherapy to be more effective with a greater chance of removing all veins within a cluster without any incisions.

Endovenous Ablation (laser or radiofrequency) is primarily used to treat Great or Small Saphenous Vein insufficiency. It has replaced vein stripping. Microphlebectomy is not an alternative to Endovenous Ablation.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Sep 15, 2010

Both procedures are done for different reasons-ELA is to close or ablate the refluxing valves in the saphenous system or accessory veins, and microphlebectomies are done to remove the bulging varicose veins.

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Answered by Vanish Vein and Laser Center

Both procedures are done for different reasons-ELA is to close or ablate the refluxing valves in the saphenous system or accessory veins, and microphlebectomies are done to remove the bulging varicose veins.

Published on Jul 11, 2012


Heart and Vein Center

Published on Oct 28, 2009

Microphlebectomy is used for the convoluted (twisted) superficial varicose veins. Most of the time after performing EVLT of the greater saphenous vein. The laser fiber cannot travel into the "twisted" varicose veins. On the other hand the use of laser on very superficial veins can potentially (unless some precautions are taken) damage the skin and create serious skin burns and ulcers.

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Answered by Heart and Vein Center

Microphlebectomy is used for the convoluted (twisted) superficial varicose veins. Most of the time after performing EVLT of the greater saphenous vein. The laser fiber cannot travel into the "twisted" varicose veins. On the other hand the use of laser on very superficial veins can potentially (unless some precautions are taken) damage the skin and create serious skin burns and ulcers.

Published on Jul 11, 2012


General Vascular Surgery Group

Published on Oct 28, 2009

These are two different procedures. Ablation to treat the feeding veins to the varicosities, and phlebectomy to treat the varices themselves. The procedures are generally complementary.

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Answered by General Vascular Surgery Group

These are two different procedures. Ablation to treat the feeding veins to the varicosities, and phlebectomy to treat the varices themselves. The procedures are generally complementary.

Published on Jul 11, 2012


Vein Specialists

Published on Oct 28, 2009

Endovenous closure (elt, elas, ela or RF) is appropriate for closure of the
superficial system of veins when significant insufficiency is noted on
diagnostic ultrasound in the presence of significant symptoms of
insufficiency such as swelling aching or skin changes ulceration or painful
bulging varicose veins. Stripping of the saphenous veins and it's straight
segment branches should not need to be performed with the availability of
endovenous techniques. Microphlebectomy is still indicated for the removal
of large superficial bulging varicose veins which typically originate from
the great or small saphenous veins.
Microphlebectomy is not any more invasive than laser or radiofrequency
ablation, as long as the incisions are kept small and adequate tumescent
anesthesia is used to help in the dissection of the vein away from the
surrounding tissues.

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Answered by Vein Specialists

Endovenous closure (elt, elas, ela or RF) is appropriate for closure of the
superficial system of veins when significant insufficiency is noted on
diagnostic ultrasound in the presence of significant symptoms of
insufficiency such as swelling aching or skin changes ulceration or painful
bulging varicose veins. Stripping of the saphenous veins and it's straight
segment branches should not need to be performed with the availability of
endovenous techniques. Microphlebectomy is still indicated for the removal
of large superficial bulging varicose veins which typically originate from
the great or small saphenous veins.
Microphlebectomy is not any more invasive than laser or radiofrequency
ablation, as long as the incisions are kept small and adequate tumescent
anesthesia is used to help in the dissection of the vein away from the
surrounding tissues.

Published on Jul 11, 2012


Angelo N. Makris MD

Published on Oct 28, 2009

Microphlebectomy is usually performed in conjunction with an ablation.
In my opinion, the results are better if a microphlebectomy is done
after an ablation in patients with bulging varicose veins. However, if
a patient does not want it, I have done just the ablation alone.



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Answered by Angelo N. Makris MD

Microphlebectomy is usually performed in conjunction with an ablation.
In my opinion, the results are better if a microphlebectomy is done
after an ablation in patients with bulging varicose veins. However, if
a patient does not want it, I have done just the ablation alone.



Published on Jul 11, 2012


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