Ambulatory Microphlebectomy

Problem: Varicose Veins

Normally, veins return blood from the rest of the body to the heart. Veins must work against gravity to transport blood to the heart. Muscle contractions in the lower legs work as pumps and elastic vein walls help return blood to the heart. Tiny valves in the veins open to allow blood to flow towards the heart and close to keep blood from flowing backwards. Varicose veins occur when the valves in the veins do not close properly and allow blood to flow backwards. The blood pools in the vein, which causes the vein walls to weaken and expand, leading to varicose veins.

Vein problems often run in families, but there are some other factors that lead to their development. Some risk factors include:

  • The risk of developing varicose veins increases with age. Over time, the valves in the veins can become damaged from wear and tear.
  • Women are more likely to develop varicose veins than men.
  • Extra weight. Being overweight putts added pressure and stress on the veins, which can weaken their valves.
  • Standing or sitting in the same position for extended amounts of time is not good for blood flow.



            The first treatment option for varicose veins is conservative therapy such as compression stocking. Compression stockings squeeze the leg while being worn, which helps the muscles and veins work properly in returning blood to the heart.

Should conservative therapy fail to improve symptoms, there are additional treatment options. One option is microphlebectomy. This treatment allows for the removal of large varicose veins near the surface through very small incisions that usually do not require stitches. It is usually combined with another form of treatment such as endovenous laser ablation (EVA). To perform a microphlebectomy, Dr. Robbins will first mark the veins being treated and then numb the skin around the veins. A very small incision is made on top of the veins and Dr. Robbins uses a tiny hook to pull the vein through the skin. A pulling sensation may be felt, but not pain. The incisions are then bandaged, and compression stockings applied. The stockings should be worn for 24-72 hours immediately following the procedure and then during the day for at least 1 week after the procedure.

This procedure is minimally invasive and is done in our office. Some risks of microphlebectomy include the following: thrombophlebitis, hyperpigmentation (brown coloring) of the skin, superficial clot formation, and allergy. Depending on the size and severity of the varicosity, retreatment is sometimes necessary.