Ambulatory Phlebectomy (AP) or Microphlebectomy

Ambulatory Phlebectomy (AP) is the recommended treatment for your varicose veins because not all veins can be treated with sclerotherapy. Some varicose veins are too large and will not close with sclerotherapy. Ambulatory Phlebectomy was originally developed in Europe and is now commonly performed in many areas of the United States. This procedure is minimally invasive and performed through a pinhole puncture. This technique permits removal of almost all larger varicose veins as an office procedure performed under local anesthesia. It is often used in conjunction with sclerotherapy to reduce the pressure in the smaller telangectatias and spider veins resulting in more efficient sclerotherapy. Ambulatory Phlebectomy is part of a complete program to eliminate unsightly or painful leg veins. With the Ambulatory Phlebectomy, almost all varicose veins in the leg can be successfully treated in the office with an excellent cosmetic result with little or no "down time." This technique differs dramatically from vein stripping and should not be confused with that procedure. It is far less invasive since only the large surface varicose veins are removed.

You will return to the office 1 week following surgery. On this visit, your compression dressing will be removed and your incision checked. You will continue wearing the surgical stocking until your next appointment, two-weeks later.

Two weeks following the surgical procedure, you will return for a follow-up visit. At that time the deeper sections of the vein will be treated using the ultrasound guided injection technique. This is less invasive and fairly comfortable. Furthermore, since the surface branches have been removed, the chemical medication will not travel up toward the skin and cause inflammatory changes as often seen when trying to treat large surface veins with injections. You may return to work the same day as the injections. You will wear the stocking for another 7 to 14 days following this treatment.

Mini Ambulatory Phlebectomy (Mini-AP)

Mini Ambulatory Phlebectomy (Mini AP) is an outpatient procedure for the removal of small and medium size veins for cosmetic purposes. The procedure was designed as an alternative to vein stripping and multiple ligations, which correct the problem but the cosmetic results are not as successful as the Mini AP. The other surgical procedures leave unsightly scars and need a longer recovery period. Injections into veins this size require multiple visits and may leave staining of the surrounding skin. With the Mini AP, these complications are avoided. This procedure does not remove any associated spider veins but these can be treated later when the healing is complete.

This simple procedure is done in the office with or without sedation. A local anesthetic is used to numb the skin around the vein. The vein is then removed through tiny punctures. The procedure is performed in a single 30-60 minute session. Immediately afterwards a dressing is applied to the leg, which stays in place for 4 days. Post procedure instructions are provided on the day of the procedure. There are few physical limitations. We will encourage daily walking and a return to normal routine activities. Patients return to the office in 2 weeks for a leg check. After 4 weeks you may begin treatment of any associated spider veins.