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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?
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.
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.
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.
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.
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
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.
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.
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.
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.