I want to have my varicose veins on my legs addressed. Are there certain circumstances where microphlebectomy is better than endovenous ablation? Or vice versa?
These are separate procedures for different problems. EVLA is to seal the malfunctioning saphenous vein (long, short, accessor) from the inside. It is a deeper vein. Phlebectomy is used to remove the bulging varicose veins at the surface. I typically do both at the same setting so my patients only need to have one down time/off work, etc., and it is also more cost effective for them.
Published on Jul 11, 2012
When venous insufficiency is diagnosed in one of the superficial veins like the great saphenous vein and/or small saphenous vein, one procedure of choice that is used to target the vein is radiofrequency ablation. Ambulatory phlebectomy is a minimally invasive procedure also referred to as phlebectomy or microphlebectomy that is used to remove varicose veins directly underneath the skin in cases not related to saphenous vein reflux, or to treat those varicose and spider veins that remain even after treating underlying venous insufficiency with endovenous ablation.
I Hope this helps. Thank you for your question.
Published on Jul 11, 2012
Endovenous ablation is commonly done along with micro-phlebectomy in the same setting or staged as an another procedure if there are too many bulging veins. There are some studies which showed doing micro-phlebectomy alone for the bulging veins can reverse venous reflux in the saphenous veins, and that is an option. If you go for this 2nd option, you would not need ablation and can be followed up to see if the venous reflux has resolved in the truncal veins.
Published on Jul 11, 2012
Varicose veins are usually the result of malfunctioning valves in feeding veins. A venous ultrasound is necessary to find the malfunctioning valves. If there are refluxing (abnormal) valves then these are first treated with an ablation, then the varicose veins are treated by microphlebectomies. If no refluxing valves are present then the varicose veins can be treated without doing an ablation first.
Published on Jul 11, 2012
Generally these are combined procedures in my practice. The ablation takes care of the feeder vein and the phlebectomies remove the surface veins.
Published on Jul 11, 2012
We typically do both procedures together. The phlebectomies remove the bulging veins on the surface (alters the appearance of the leg) and the ablation closes the underlying vein that is causing the unsightly veins (the source of the problem).
Published on Jul 11, 2012
Endovenous thermal ablation requires a relatively straight vein in order to pass the catheter or LASER fiber. Microphlebectomy is utilized for more tortuous varicose veins near the skin.
Published on Jul 11, 2012
Microphlebectomy is usually done in conjunction with an ablation if there are large varicose veins.
Published on Jul 11, 2012