What is a Phlebectomy?
Phlebectomy (also called microphlebectomy) is a procedure that removes varicose veins through small incisions (cuts) in the skin. This procedure helps treat and manage varicose vein symptoms, including:
- itching,
- swelling,
- skin color changes,
- pain or heavy feeling in your legs, and
- large or bulging veins on the surface of your skin.
We typically perform phlebectomy procedures at the same time as vein ligation and stripping surgery when appropriate.
Why Choose U of U Health?
Our vascular surgeons use advanced treatment options to help relieve any symptoms associated with varicose veins. Our team is made up of board-certified vascular surgeons who specialize in treating all types of disease affecting your veins and arteries.
We take a comprehensive approach to treating different types of venous disease, such as venous insufficiency and varicose veins. We address the symptoms and find the underlying cause for your vein issues to give you long-lasting relief. We offer both minimally invasive procedures (such as endovenous laser ablation therapy) and open surgery to treat vein diseases.
Your varicose vein treatment will be based on your body and your diagnosis. Our providers will review all your options with you and help you choose the one that works best for your needs.
Best Candidates for Phlebectomy
Varicose vein treatments are unique to each person. We usually recommend phlebectomy procedures for larger veins near the surface of your skin because they can be removed through small incisions (cuts).
However, phlebectomy is not the right treatment for all varicose veins. You should not get phlebectomy if:
- your varicose veins are deep inside your legs,
- you have an active skin infection, or
- you have a blood clot or high risk of blood clots.
Find a Vascular Surgeon
What to Expect at Your Next Appointment with a Vascular Surgeon
At your first appointment, one of our vascular surgeons will perform a physical examination of your varicose veins and discuss your medical history. We will use a small handheld ultrasound device called a transducer to look at how well blood flows through your veins.This helps us see if you have venous insufficiency, (a condition where blood doesn’t flow properly through your veins), which leads to varicose veins.
We will review the results of your exam and discuss the best options for treatment. We may recommend non-surgical treatments first, such as compression stockings. If we decide that a phlebectomy procedure is the best choice, we will schedule you for the procedure.
Phlebectomy Procedure
We will typically perform this procedure in the operating room at the same time as another procedure known as vein ligation and stripping, if needed. You will be put to sleep via anesthesia. We will clean and sterilize the areas on your leg where we plan to make the incisions (cuts). A local anesthetic will be injected to numb the area right around your vein to reduce any post-surgical pain.
Your vascular surgeon will make very small slits in your skin. They will use a small instrument that looks like a hook to find the varicose vein, and pull out as much of the vein as possible. After part of the vein is taken out, your vascular surgeon will tie off the ends of the vein so no more blood can flow through it. Your surgeon may need to make several small incisions (sometimes 20 or more) to remove all the varicose veins.
Your incisions will be stitched and covered with small bandages to heal like a normal cut. The stitches will dissolve on their own and do not need to be removed.
A phlebectomy usually takes about 30 to 60 minutes. However, the procedure could take up to two hours if it's done at the same time as a vein ligation and stripping. You will go home the same day as your phlebectomy, but you'll need someone to drive you home after the procedure because you cannot drive after being under anesthesia.
Phlebectomy Recovery Time
On the day of surgery, you may experience some mild pain from the incisions (cuts). Take over-the-counter pain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), if you experience any pain. Talk to your provider about any other medications you take and follow their instructions on any changes to your medication.
The doctor will put ACE wraps and gauze on your leg after surgery. They will also give you compression stockings to take home. You can take your bandages off the day after surgery, but continue wearing your compression stockings for two to three weeks while your leg heals.
Signs of Healing after Surgery
For one to two weeks after surgery, you may experience:
- slight bleeding through your bandages,
- bruising,
- pain,
- soreness, or
- a tingling sensation in your leg.
Use NSAID pain medication and an ice pack to relieve pain and soreness. You can also elevate your leg above your heart for further pain relief and to reduce bleeding.
Returning to Daily Activities
Most people will resume their normal daily activities 24 hours after surgery. You'll also be able to Most go back to work within one to two days. If you work in a manual labor or have a job that requires you to be on your feet a lot, talk to your doctor about when it’s safe to go back.
Phlebectomy Risks
Phlebectomy procedures are safe, but they do come with some risks, such as:
- infection at the incision site,
- permanent changes in skin color where your varicose veins were removed,
- bleeding,
- extensive bruising or blood that collects under your skin (hematoma), or
- numbness and tingling that lasts longer than a couple of days.
If you are concerned about any of these symptoms, contact our office right away.
Schedule an Appointment with a Vascular Surgeon
Call 801-585-7676 to meet with one of our vascular surgeons.
A referral is not required to see a vascular surgeon at University of Utah Health. However, some insurance plans may require a referral from your primary care provider (PCP) to see a specialist. Check with your insurance carrier if you have any questions about your coverage.
