When should one have microphlebectomy versus endovenous ablation procedures?

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?

Answers from doctors (8)


Vein Specialties of St. Louis

Published on May 15, 2018

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.

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Answered by Vein Specialties of St. Louis

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


More About Doctor Vein Treatment Clinic

Published on May 14, 2018

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.

Answered by Vein Treatment Clinic (View Profile)

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.

Answered by Mid-Atlantic Institute of Venous and Lymphatic Medicine (View Profile)

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


Vanish Vein and Laser Center

Published on Sep 05, 2010

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.

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Answered by Vanish Vein and Laser Center

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


General Vascular Surgery Group

Published on Jan 15, 2010

Generally these are combined procedures in my practice. The ablation takes care of the feeder vein and the phlebectomies remove the surface veins.

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Answered by General Vascular Surgery Group

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


VeinSolutions - Edina

Published on Jan 14, 2010

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).

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Answered by VeinSolutions - Edina

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


VeinCare Centers of Tennessee

Published on Jan 14, 2010

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.

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Answered by VeinCare Centers of Tennessee

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


Angelo N. Makris MD

Published on Jan 14, 2010

Microphlebectomy is usually done in conjunction with an ablation if there are large varicose veins.

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Answered by Angelo N. Makris MD

Microphlebectomy is usually done in conjunction with an ablation if there are large varicose veins.

Published on Jul 11, 2012


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