Vein ligation and stripping are two surgical procedures used for the treatment of varicose veins, which are large, swollen surface veins that usually occur in the legs. Stripping and ligation have been standard procedures for varicose veins since the early 20th century with only a few changes. However, due to newer, non-surgical treatments of varicose veins, fewer doctors today perform vein stripping surgeries.
In any case, varicose veins and their various treatments are highly individualistic, and a doctor should always be consulted as to which is the best treatment for you.
Who is and isn't a candidate for vein surgery?
Vein ligation and stripping are suggested for larger varicose veins. For smaller varicose veins or spider veins, sclerotherapy may be a better option.
You may not be a good candidate for vein surgery if you:
- Are pregnant
- Have a history of poor circulation in the legs
- Have blockage in the deep venous system
- Have swelling related to lymph blockage
- Have recurrent incompetence after a previous surgery
- Are older and for whom any type of surgery is not recommended
What happens during vein stripping and ligation procedures?
Vein ligation and stripping are both performed by a specialist in a clinical setting, and are often performed together. For less severe cases, vein ligation is performed alone.
In vein ligation, a local anesthetic is applied before making small incisions along the problem vein, which is then tied off at the faulty valve. Since the problem areas are tied off but the healthy vein is left intact, blood flow then redirects itself to the healthy portion of the vein.
In vein stripping, a local or general anesthetic is applied before making two incisions along the leg, one near the groin and one near the knee. After these incisions are made, the two ends of the faulty vein are snipped and tied off. The surgeon will then feed a stripping wire along the length of the vein and will proceed to remove the vein, which is known as stripping the vein. This allows the blood flow to redirect itself to healthier passages, while the problem passage is removed entirely.
What is the recovery period like?
You can return home the same day the procedure is performed. People are usually able to return to work and other regular activities within a few days. Compression stockings will need to be worn for the following two weeks—24 hours a day for the first week and only during the day for the second week. More time may be required at the suggestion of your doctor. Pain medication may also be prescribed for the following few weeks.
What are the results and risks of vein ligation and stripping?
Most patients experience immediate and long-lasting relief from the pain associated with varicose veins, as well as improved appearance of their legs.
Risks associated with vein ligation and stripping include scarring and the return of varicose veins. If there is also damage to the deep vein system of the legs, these procedures can increase problems with blood flow, which is why a full diagnostic examination with ultrasound mapping is an important step in determining if vein ligation and stripping is right for you.
Additional risks with vein ligation and stripping include the usual risks associated with any type of surgery, such as infection or bleeding.
What are alternatives to vein stripping and ligation?
A newer procedure known as endovenous ablation has gradually come into popular use. This procedure involves making a single needle point into the leg rather than incisions. A laser or thermal fiber is then fed through the faulty vein. The laser then heats the lining of the vein as it is pulled out, causing the vein to collapse, shrink, and eventually disappear. Studies have shown that this procedure leaves a less noticeable scar, lets patients return to work more quickly, and has fewer post-operative complications.
Is vein surgery covered by insurance companies?
Vein ligation and stripping may be covered by medical insurance if the procedures are considered medically necessary, such as when patients experience painful symptoms. If patients pursue vein surgery solely for cosmetic purposes, it is generally not covered by medical insurance.
How much does vein surgery cost?
A number of factors influence the cost of vein surgery, including the combination of procedures required, geographical location, surgeon’s fees, and the number of veins to be treated. To confirm the cost of receiving vein ligation and stripping in your area, contact a local vein specialist to schedule a consultation.
Reviewed February 3, 2017