Definition
Varicose vein treatment involves taking out or causing damage to varicose veins just under the skin.
Different procedures may involve:
- Sclerotherapy—injects the varicose veins with a chemical to shrink them
- Radiofrequency ablation—collapses and seals varicose veins using radiofrequency energy
- Adhesive sealing—seals the affected veins that are close to the skin
- Vein stripping—surgery to take out the affected vein
- Phlebectomy—small incisions and a needle or small scalpel are used to remove the affected vein
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Reasons for Procedure
The procedures may be done to treat or prevent problems from various veins, such as:
- Burning, aching, or throbbing
- Blood clots in the legs
- Discolored skin and ulcers
- Not liking the way the veins look
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Return of varicose veins
- Bleeding
- Infection
- Changes in skin color at the surgical site
- Deep vein thrombosis
Smoking may increase the risk of having these problems.
What to Expect
Prior to Procedure
The doctor may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
- Fasting before the procedure, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from the procedure
- Tests that will need to be done before the procedure
Anesthesia
The anesthesia will depend on the type of procedure. The doctor may give:
- General anesthesia—you will be asleep
- Spinal anesthesia — you will be numb from the belly down
Description of the Procedure
A chemical will be injected into each of the damaged veins. It will scar the vein so that it cannot move blood.
A small tube will be inserted into the damaged vein. An ultrasound is used to view the placement of the tube. An adhesive is injected into the tube to seal the vein.
The vein will be viewed using an ultrasound. Then, the vein will be punctured near the knee. A tube will be threaded up to the groin. The space between the vein and the skin will be filled with a special solution. This solution will numb the area. The tube will then be attached to a radiofrequency generator or a laser. Heat or light energy will seal the vein closed.
Incisions are made in the top, middle, and bottom of the leg. The veins will be removed by threading a long wire into them. Each vein will be tied to this wire and then stripped out. This will leave the smaller side branches broken off and in place.
Many small incisions will be made to access each varicose vein. The vein will either be tied off or removed.
After the Procedure
If vein stripping is done, the leg will be tightly wrapped. This is to prevent blood from leaking out of the veins.
How Long Will It Take?
- Sclerotherapy—short office visit
- Adhesive sealing—short office visit
- Radiofrequency or laser ablation—1 hour
- Vein stripping—1 to 1½ hours
- Phlebectomy—2 to4 hours
Will It Hurt?
There will be some discomfort after the procedure. Medicine will help ease pain..
Post-procedure Care
Recovery time varies. It depends on the procedure. Surgery will take longer—up to a few weeks.
Call Your Doctor
Call your doctor if you have:
- Fever or chills
- Excess bleeding, redness, swelling, or discharge from the incisions
- Pain that you cannot control with the medicine
- Problems passing urine (pee)
- Coughing, breathing problems, or chest pain
- Leg swelling
If you think you have an emergency, call for medical help right away.
RESOURCES
American College of Phlebology http://www.phlebology.org
Society for Vascular Surgery https://vascular.org
CANADIAN RESOURCES
Canadian Society for Vascular Surgery https://vascular.ca
Health Canada https://www.canada.ca
References
Varicose veins. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/varicose-veins. Accessed September 9, 2021.
Varicose veins. Society for Vascular surgery website. Available at: https://vascular.org/patient-resources/vascular-conditions/varicose-veins. Accessed September 9, 2021.
Varicose veins and spider veins. Office on Women's Health website. Available at: https://www.womenshealth.gov/a-z-topics/varicose-veins-and-spider-veins. Accessed September 9, 2021.
Zolotukhin IA, Seliverstov EI, et al. Short-term results of isolated phlebectomy with preservation of incompetent great saphenous vein (ASVAL procedure) in primary varicose veins disease. Phlebology. 2017;32(9):601-607.
Revision Information
- Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
- Review Date: 07/2021
- Update Date: 09/09/2021