Project Description

Phlebectomy – Ambulatory and Micropuncture

What does the word “Phlebectomy” mean?   The word comes from combining the following Greek words.

  • “phleb-” or “phlebo-“:  meaning “vein” (from the greek verb “phlein” meaning “to flow)
  • “ek”:  meaning “out of, away from”
  • “tome”: meaning “cutting”

Phlebectomy literally means “cutting out vein”, or “removing vein”  (Pronounced: Flee•bek•to•mee) and is used to treat phlebitis.

At Advanced Vein Care Center, we perform phlebectomy on an outpatient basis with local anesthetic which is sufficient. Phlebectomy is performed through a small 1 mm to 3 mm needle punctures in the skin rather than the traditional half-inch to one inch scalpel incisions for veins stripping, hence the term, “Ambulatory Micropuncture Phlebectomy.”    After removing larger varicose veins, the puncture marks are so small, they do not require stitches.  Our phlebectomy scars are barely visible for some people, and for others, they blend in with their natural skin freckles.  They are noticeable only on patients who have pale skin color with no freckles or skin pigmentation.

It is very important to note that Ambulatory Phlebectomy is a supplemental procedure to EVLT.  Varicose veins on the skin surface arise from an underlying vein source that is refluxing.  In other words, varicose veins that are treated by phlebectomy are only the surface manifestation of an underlying venous insufficiency.  As such, it does not make sense to simply remove the varicose veins without treating the underlyling refluxing veins.  For this reason, most insurance companies cover ambulatory phlebectomy only after the EVLT procedure is performed.  Therefore, ambulatory phlebectomy should be considered as an associated procedure to EVLT.  And as one might expect, the benefits and risks of ambulatory phlebectomy are very similar to those of EVLT.

Ambulatory Micropuncture Phlebectomy: Questions & Answers

Does everyone need Phlebectomy after EVLT?
If I have a lot of varicose veins, how long will it take to remove all of them?
Who performs Phlebectomy in your office?
How soon after EVLT will you be performing Phlebectomy?
Does Phlebectomy procedure hurt?
Do they come back?
How much does it hurt afterward?
When can I go back to work after Phlebectomy?

Before, During, and After Questions & Answers

Before the Procedure: Preparation

Can I drive myself to the Phlebectomy procedure appointment?
Will I be given any sedative pills before the procedure?
Will I have to put EMLA cream on my leg just like I did for EVLT procedure?
Where on my leg do I put EMLA cream?
What if I have to put EMLA cream on where the bulky gauze dressing is (placed after EVLT)?
Can I take a shower before Phlebectomy?
What about pain medications before the procedure?
I am on Coumadin (Warfarin). Do I have to stop my blood thinners prior to Phlebectomy?
What about other blood thinners before Phlebectomy?
Do I have to avoid drinking coffee or other caffeine-containing food/drink products before Phlebectomy?
What do I bring to the Phlebectomy appointment?

During the Procedure

Will I have a chance to use the Restroom before the procedure?
Can I have someone stay with me in the room during the procedure?
Can I bring my iPod and listen to music? Or bring my iPad?
What happens immediate before the Phlebectomy procedure?
What happens during the Phlebectomy procedure?

After Procedure Care

For how long after Phlebectomy do I have to wear compression stockings (CS)?
I see spots of blood seeping through the bandage and compression stocking. What do I do?
When I stood up, there was enough oozing that it soaked right through the gauze pad and stained the compression stockings. Should I be concerned?
When can I shower after Phlebectomy?
Where the phlebectomy was performed, there is a "knot" under the skin. Is that normal?
What about the spider veins? I have these ugly spider veins on the leg. What abut those?
How soon after EVLT and Phlebectomy can I go to the beach or lie under the sun?

The rest are the same as for AFTER-Endovenous Laser Treatment in terms of the following:

  • Pain management
  • Return to work
  • Return to activity and exercise
  • Concerns about bruising and redness
  • Travel by car or airplane for prolonged periods

Contact Us

We look forward to answering any remaining questions you may have about vein removal and ambulatory phlebectomy. Our friendly and informed Springfield, MA office can be reached by phone at (413) 732-4242 or fill out the form below.