- Treatments & Info
- Find a Doctor
- Ask a Doctor
- Before & After
I had varicose vein surgery a few years ago on my left leg. After the surgery, it was painful. I may need to treat my right leg but I don't want to go through that again. What would be the best alternative?
We routinely remove veins in an office setting using local anesthetic and 2 mm incisions that do not require sutures. The patients drive themselves to and from the procedure and can resume most activities the next day. They rarely take anything for pain.
Good news! Most saphenous veins can now be treated with either thermal ablation or duplex-guided sclerotherapy. Both are non-surgical office procedures which are widely available and avoid the costs, scars, and post-op pain of surgery.
Many times these veins can be eradicated with vein ablation (either laser or radiofrequency) see a vein MD and have an evaluation. Usually a vein stripping is no longer needed.
Ambulatory phlebectomy is usually not as painful as stripping of the saphenous vein. Occasionally, sclerotherapy can be utilized. Your vein specialist can perform an ultrasound and advise appropriately.
The visible varicosities usually result from an abnormality of an underlying large vein. These large veins (saphenous or perforators) can be treated with endovenous ablation. The visible varicosities will then reduce in size. At that point, you and your doctor can decide if the varices need further treatment for elimination. If they are markedly reduced, the veins can be left alone or can be further treated with sclerotherapy injections. If the varices are relatively large, they may require removal via miniphlebectomies.
Stripping is not necessary to effectively treat vein issues. One of the best methods is endovenous laser treatment(EVLT).
Stripping is no longer necessary to treat varicose veins.
Vein stripping is a procedure which should only occasionally be performed since endovenous thermal ablation has become widely available. Be sure you see a physician who is experienced in endovenous thermal ablation, minimally-invasive microphlebectomy, and foam sclerotherapy so the appropriate minimally-invasive procedure may be offered to you.
You do not have to have vein stripping any more. I am surprised you had stripping a few years ago. There has been improved treatment for veins since at least 2000. However, it is physician preference. Have a consult with a vein specialist. It should include an ultrasound, which will determine how the veins are functioning. Following the results of the ultrasound, treatment options can be recommended.
Endovenous closure has been the gold standard for the treatment of the
underlying cause of varicose veins for the past 10 years. Stripping is no
longer used and should not be part of the conversation. Removal of
recurrent bulging veins years after a stripping procedure or other procedure
within the past 10 years should only be performed after a good venous
insufficiency ultrasound has been performed to exclude any other leaky veins
as the source of the varicose veins. Surgical removal of bulging varicose
veins is also known as microphlebectomy (micro=small, phleb=vein,
ectomy=removal) and is sometimes required to achieve the best result.
If you have varicose veins then the best alternative would be a venous ultrasound, followed by a laser closure procedure and microphlebectomies. If you have varicose veins then most likely you also have vein reflux.
There are alternatives to treating varicose veins without having to undergo procedures that require incisions (stripping, phlebectomy, etc). Less invasive procedures include radiofrequency ablation or EVLT (Endovenous laser), combined with adjunctive sclerotherapy. Such procedures avoid incisions, provide excellent short and long-term results, and have significantly shorter and less painful postoperative courses. You should seek the opinion of a trained specialist in all aspects of vein care, most preferably a vascular surgeon dedicated to the field of phlebology.