Microphlebectomy is a minimally invasive surgical technique used to eliminate unsightly or painful leg veins. This is the recommended treatment for large surface varicose veins. Due to their size, these veins cannot be effectively treated with sclerotherapy. Removal of the unsightly, painful veins with microphlebectomy results in quicker healing, less pain, and a better cosmetic result than would occur without this treatment. This technique differs dramatically from surgical vein stripping and should not be confused with that procedure. Because only the large surface varicose veins are removed, microphlebectomy is far less invasive than surgical stripping. Recovery is more rapid, and a majority of patients do not need to interrupt regular activity after microphlebectomy. This treatment takes approximately one hour to perform.
Who should have this procedure?
If you have varicose veins, you may be a candidate microphlebectomy. To find out whether you might benefit from microphlebectomy, call our office to schedule a consultation with one of our physicians to assess your treatment options.
When is the microphlebectomy procedure offered?
Microphlebectomy is performed for the treatment of large dilated surface varicose veins. To prevent recurrence of these veins, microphlebectomy is usually combined with or preceded by endovenous laser treatment or radiofrequency ablation of the greater or lesser saphenous vein(s). Both the greater and lesser saphenous veins feed into the surface varicose veins and should be treated prior to the microphlebectomy procedure to prevent blood flow and reappearance of these unsightly surface veins.
How is microphlebectomy performed?
This procedure is performed in a comfortable outpatient setting using only local anesthetic. The vein(s) to be removed are outlined, and the leg is washed and prepared for treatment. Abnormal or diseased veins are accessed and removed through a series of pinhole perforations using a special set of instruments. Because microphlebectomy is performed through small needle punctures, it is far less invasive than vein stripping, which is performed through incisions.
What can I expect after the procedure?
Following the procedure, the small punctures are closed with Steri-Strip bandages, and a compression wrap is applied to the treated leg. You will be asked to walk for at least 20 minutes immediately following your treatment. A prescription-strength compression stocking will need to be worn for about two weeks following the procedure to achieve maximum healing and results, and avoiding exercise for the same period is encouraged. Most patients do not need to interrupt other regular activity after microphlebectomy.
What are risks and side effects of this procedure?
As with all medical procedures, there are some risks associated with microphlebectomy. These risks include bleeding, infection, swelling, allergic reaction to the local anesthetic, postoperative pain, discoloration of the surgical field, and small patches of numbness in the treated area. These risks are all very rare. Treated veins will not come back, but the prevention of new varicose veins from new sources cannot be guaranteed by this procedure.
Does insurance cover microphlebectomy?
Many insurance carriers (including Medicare) do provide coverage for microphlebectomy. Unfortunately, not everyone is a candidate for coverage. Carriers will cover the procedure only when deemed medically necessary. Patients must demonstrate symptomatic venous reflux disease to be considered for coverage. Symptoms associated with venous reflux disease are: pain, swelling, leg cramps, ulcers, bleeding from varicosities, etc. Patients are also required to try conservative treatment before being considered for coverage. Insurance companies will also want to see ultrasound results to determine the presence of reflux in the diseased vein(s). You may find it helpful to contact your insurance company if you have further questions about coverage.