What is Phlebectomy?

Phlebectomy (also known as microphlebectomy, ambulatory phlebectomy, or stab avulsion) is a technique to remove varicose veins. In this procedure, several tiny cuts (incisions) are made in the skin through which the varicose vein is removed.

What is the purpose of a Phlebectomy?

The stab phlebectomy procedure removes large ropey varicose veins where other methods will not work for a patient.

How is the procedure performed?

This is a surgical procedure where tiny incisions are made directly over a large varicose vein, then the vein is removed in specific sections. Often, just a few incisions are required in order to really make a difference in the cosmetic appearance of the veins. These incisions are very small, usually less than half a centimeter, and do not produce a lot of pain. The stab phlebectomy procedure is usually performed in our surgery center. Often, it is performed in conjunction with a more definitive vein surgery for venous insufficiencies, such as radiofrequency ablation.

Will the procedure be painful?

The stab phlebectomies are minimally invasive and involve little pain. You may have some discomfort following surgery. We will prescribe a prescription for pain medicine to be used as needed, and an anti-inflammatory to be taken as ordered for ten days.

What are the discharge instructions?

We would like you to continue to keep moving and maintain a normal level of activity. Walking twice daily for 20 minutes is encouraged and promotes speedy healing. Several days after the procedure you may get some inflammation on the inner aspect of your thigh. This inflammation is part of the process and is to be expected. Walking and taking your anti-inflammatory medication as prescribed will help to alleviate the discomfort. After three days you may remove the dressing by unwrapping it. Under the wrap will be 4x4’s which may also be removed. When the outer dressing is removed you will notice a significant amount of bruising, this is to be expected. There will be steri-strips covering the small incisions where the vein was removed. These stay in place, do not remove them.
After the dressing has been removed you may shower and wash the leg as normal. After several showers, the steri-strips will begin to come loose and you may remove them after one week. You are to continue wearing the compression hose for another ten days, during the day. You may remove the hose at night after the dressing is removed.

Can I exercise?

Strenuous exercise and any heavy lifting are not recommended for at least four weeks following your procedure, but that doesn’t mean you should be inactive. A regular walking routine improves your overall circulation and helps to prevent clots. You needn’t go far — a few hundred yards three times a day should do the trick. As the stiffness gradually decreases, you can ramp up your strolls.
You may also want to know when you can drive your car. Since your reaction times may be slowed due to the anesthesia and any lingering discomfort in your leg, wait for at least 24hours before getting behind the wheel.

You may have an allergic reaction to any of the local anesthetics used. If you have a known allergy to any medications, especially local anesthetics, notify our staff before the procedure takes place.

You may experience moderate discomfort and soreness in the area of treatment for about 24 hours. If this occurs, take anti-inflammatories or pain medications, and apply moist heat in the day(s) following.

What are the risks and side effects?

The small stab wound punctures into a vein do not cause any serious problems. Some may experience dizziness, a small amount of bleeding, bruising, discomfort, pain, and rarely infection. Local anesthesia will be used to minimize discomfort. Rarely, you can have or develop allergies to medications used during the procedure, including local anesthetics and skin cleansing agents. Serious complications are rare but can result in the need for additional surgery. It is extremely rare but amputation or even death can occur. 

How long does it take for the procedure to work?

For most patients, full recovery takes about three to four weeks. That said, if you received treatment for both of your legs, you can expect a longer recuperation period. 

Does my insurance cover this procedure?

Stab Phlebectomy is usually covered by most private insurers and Medicare when proof of medical necessity and previous conservative therapy is provided. Patients should consult their individual insurance carriers to determine their eligibility.