Ambulatory phlebectomy is a common type of varicose vein treatment. However, sclerotherapy and various forms of laser treatment are usually preferred over ambulatory phlebectomy. However, there are certain circumstances when ambulatory phlebectomy is recommended instead of the more popular forms of varicose vein treatment. There are also times when ambulatory phlebectomy is combined with sclerotherapy or some form of laser treatment. Below is a full discussion of this issue.
What Is Ambulatory Phlebectomy?
It is probably best to start with a description of ambulatory phlebectomy, and contrast that briefly with sclerotherapy varicose vein treatment and laser varicose vein treatment.
In sclerotherapy, a chemical is carefully injected into a varicose vein with the goal of “ablating” it. This means the vein closes and blood can no longer flow into the ablated vein. However, the collapsed vein is not removed. Instead, it is left in place, and then through the natural healing process of the body, the vein is reabsorbed and the tissues recycled, just as the scar tissue of an injury would be.
Laser focused varicose vein treatment works much the same way as sclerotherapy, except instead of a chemical, laser energy is used to “ablate” the varicose vein. The final result is the same. The vein collapses, i.e. seals off, allowing no more blood to flow into it. The ablated vein is not removed and the body reabsorbs the tissue.
The biggest difference between sclerotherapy and laser varicose vein treatment versus ambulatory phlebectomy is that the varicose is actually REMOVED from the body during the procedure. It is NOT left in place for the body to reabsorb. Instead, very tiny incisions, usually no more than five millimeters in length (about one-fifth of an inch), are made in the skin just above the varicose vein. Then, using a “hook and grab” microtool, the vein doctor first cuts and then extracts the varicose vein, one tiny segment at a time.
When Is Ambulatory Phlebectomy Preferred?
Ambulatory phlebectomy is often recommended for a superficial varicose vein that is particularly large and bulging out. However, it can also be performed on reticular veins (feeder veins) that feed into superficial veins. When a superficial vein is large and bulging, the vein doctor may believe it is too large to be reabsorbed well after sclerotherapy or laser varicose vein treatment. He or she may also feel that the chance of scarring or discoloration may be less using ambulatory phlebectomy exclusively or ambulatory phlebectomy in conjunction with sclerotherapy or laser varicose vein treatment.
Some varicose veins may also be too large or tortuous (twisted) to completely fill with the sclerosant, the chemical used in sclerotherapy. A laser may not work well in a tortuous vein either because the thin cable on which the laser is positioned cannot move easily through a tortuous vein. There are also some cases when it may be too dangerous to inject a sclerosant (chemical) or use laser energy. One good example of this would be varicosed peri-ocular veins around the eyes.
Concerns About Scarring
Many people become concerned about scarring during the healing process after ambulatory phlebectomy. This is because hardened areas often form around each tiny incision and scabs form on top of these as well. In some cases too, telangiectatic matting may occur. This is where tiny new vein structures, “veinlets” if you will, form into a matted web. In some cases, telangiectatic matting looks more like bruising or discoloration than actual veins, until you look very close. At any rate, telangiectatic matting can be very unattractive and give people concern there may be permanent scarring.
Although this post-operative healing phase may look and feel gruesome, most patients who undergo ambulatory phlebectomy completely heal, scar free, within a year, and often within a few months. It is always best to never pick the scabs off and just let them fall off naturally. This speeds the healing process and it reduces the likelihood of permanent scarring.
Ambulatory Phlebectomy Is NOT the same as Vein Stripping!
There is sometimes confusion that ambulatory phlebectomy is the same as vein stripping. In reality, the two procedures are not anything alike. Ambulatory phlebectomy is an outpatient procedure done under local anesthesia and you get to go home the same day. The procedure is slightly more invasive than varicose vein treatment like sclerotherapy and EVLT (laser treatment) but nowhere near as invasive as vein stripping. The healing time for ambulatory phlebectomy is also much shorter and with much less pain than vein stripping as well.
Get a Free Vein Evaluation At Metro Vein Centers
Metro Vein Centers is one of the top vein clinics in North America. They have a stellar reputation and perform a wide variety of varicose vein treatments. To get a free evaluation, all you need to do is give them a call and set up a convenient appointment. Check out their website to choose from one of several locations.