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?
Radiofrequency ablation (RFA) treats the underlying insufficient (leaky) vein that is responsible for the varicose veins. This is typically followed by microphlebectomy or sclerotherapy. It is unlikely that the RFA will take care of all your visibly large varicose veins unless they are in the direct line of the ablated vein.
Published on Jul 11, 2012
Alternatively, you should consider laser ablation (or RF ablation) with ultrasound-guided chemical ablation.
Published on Jul 11, 2012
If there is reflux (backflow) in long or short saphenous veins, sealing with either laser or radiofrequency ablation is very effective. Theoretically 50% of varicose veins will shrink down after this procedure. This leaves a 50% chance they won't. As a surgeon I typically remove the varicose veins at the same time as the patient will just have to have the one procedure/downtime and it is also more cost effective for them. Varicose veins MAY lead to problems such as clotting, skin changes and even leg ulcers if left untreated
Published on Jul 11, 2012
Microphlebectomy might not be needed if you wait several months after RF and the veins shrink on their own.
Published on Jul 11, 2012
The RF procedure is intended to ablate or seal the large truncal vein with reflux, which is connected to the bulging varices. This reduces the pressure in the veins. However, if they continue to buldge after the RF, the varices are then removed with miniphlebectomies.
Published on Jul 11, 2012
The RF procedure closes the refluxing valves but does not eliminate the varicose veins. Think of this like a tree. The trunk is treated by the RF, but the varicose veins are treated by the microphlebectomies. Usually, the varicose veins will not disappear simply by stopping the reflux.
Published on Jul 11, 2012
The RF will eliminate the main source of reflux to the varicose veins, but not all of them. Many varicose veins have multiple sources of reflux, and it is not possible to eliminate all of them. In many patients the phlebectomy, in addition to the RF or EVLT, will give a much better result and complete resolution to the varicose veins.
Published on Jul 11, 2012
This is a question you need to ask your physician, since he is treating you and making the recommendations. Without knowing all the details, and without having examined you, I cannot determine why your doctor is recommending both procedures. I can say that it is not uncommon to perform both procedures on one patient, so perhaps there is a reason for his determination.
Published on Jul 11, 2012
Microphlebectomy removes the veins after they have collapsed as a result of the RF procedure. Doing both procedures will offer better cosmetic result and reduced recurrence. We do it routinely with almost every patient.
Published on Jul 11, 2012