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Microphlectomy, Is It the Treatment for You?

For some, varicose veins are unsightly vessels that undermine an individual’s appearance and their self-confidence.  For others, they are the source of throbbing, heaviness and pain that interrupts everyday activities.

Patients with varicose veins have a number of potential therapies to consider. The Venous and Lymphatic Medicine literature examines the various treatments offered such as sclerotherapy, ultrasound-chemical ablation, thermal ablation and microphlebectomy (often called phlebectomy.)

What Exactly is a Microphlebectomy?

This is an in-office vein treatment that experienced vein specialists use to remove varicose vessels.  The New England Journal of Medicine notes that this procedure is particularly suited for removing varicose veins which are bulging and too large to treat with sclerotherapy.  These vessels are closer to the skin surface than the deeper saphenous veins.  Poorly functioning saphenous veins lead to varicose veins and those deeper saphenous veins are treated by thermal ablation treatments modalities.

After administration of local anesthesia in the clinic, the physician makes a small or pinpoint-size incision through which varicose vessels are removed by tiny surgical instrument.  As Vein Specialist we consider this a minimally invasive treatment since the procedure is clinic-based, using local anesthesia and patients are able to walk-out following their procedure, literally pain free.

What to Expect with a Microphlebectomy

During the evaluation, a medical history (venous focused) is obtained.  A venous ultrasound is performed on the initial evaluation visit. Advice is provided regarding any medication changes required as the date of surgery approaches.  Patients receive pre-procedure instructions. On procedure day, loose fitting clothing and shoes are recommended to be worn that will be comfortable enough for the required walking after the procedure.

The procedure begins with the outlining of troublesome visible vessels using a surgical marker.  Positioned onto a comfortable procedure bed, following a prep and drape, local anesthesia is then administered.  The combination of the patient position and the local anesthesia results in the varicose veins contracting down to a very small diameter size.  Dr. Pal, making pinpoint incisions and using a tiny hooked instrument easily eases the vein from the tiny incisions.  This process is repeated along the course of the marked vessel.

If you first require saphenous vein ablation for a refluxing deeper vessel, the microphlebectomy would follow this ablation procedure.  A microphlebectomy lasts one half- hour and even upwards of 1 ½ hours depending upon the length of the area to be treated. Many patients have just small areas of bulging veins while others have very long bulging veins which course down their thigh and lower legs.

Once completed a concise surgical dressing, compression wrap and stockings are applied.  Following instructions, patients are able to walk out of the clinic and even drive home if they have elected not to take mild oral sedation.  If the microphlebectomy is performed alone without need of an ablation, stockings are required for only seven days.  Patients are instructed to routinely walk (pumping the calf muscle), to avoid airline flights for 48 hours and are scheduled to return to clinic for reevaluation in seven days and also in three months.

One of the greatest advantages of a micophlebectomy is that patients have no major down time. Most activities can be resumed except for energetic workouts, baths that are long or hot, and lifting of weights.  At Minnesota Vein Center, patients are very happy to discover that in just two days after their phlebectomy when they remove their dressing, the bulging vein has disappeared and the symptoms of achiness, itching or restless leg symptoms are gone.

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