Treatments for Veins and Varicose Veins - Phlebectomy
Mark Whiteley talks about the difference between Stripping Varicose Veins and Phlebectomy
Whenever blood stops flowing, even if still inside a vein or artery, it will clot.
When this happens inside a vein, the vein becomes very hard, red and tender - a condition called thrombophlebitis.
If we have treated the underlying cause of varicose veins successfully (i.e. using EVLA, VNUS Closure®, Closure® FASTTM™, RFiTT® or TRLOP) then the lumpy veins on the surface, called the varices, will clot and cause painful thrombophlebitis.
To prevent this from happening, the varices need to be treated.
If they are small enough, they can be treated with foam sclerotherapy (see previously).
If they are larger (which they usually are) then they need to be removed physically.
Removal of the vein is called "phlebectomy". In medicine, "phleb" means vein and "ectomy" means removal.
A phlebectomy can be performed under local anaesthetic. The surgeon and draws around the vein when you're standing as when you lie down, they usually disappear.
Local anaesthetic is injected around the varices and tiny incisions are made (about 2 mm each) using a special blade called a Beaver blade.
A phlebectomy hook is then passed into the incision and each varicose vein is pulled out in turn.
Although this may sound barbaric, in fact it is an excellence technique with fantastic results - provided the underlying causes have been treated properly.
There have been attempts to produce an alternative to phlebectomy and most vein surgeons, ourselves included, would love to have an alternative.
Unfortunately no effective alternative has so far being developed that we have found to work in our hands.
Several years ago a technique called Trivex® was invented.
Trivex® used to different instruments passed into the leg.
The first was passed under the veins to illuminate them with a very bright light and to guide the second instrument, which "chewed" the veins with a rotating blade.
Although an excellent idea, and although some surgeons claimed good results, we were unable to get good results at The Whiteley Clinic using this technique.
In particular, as phlebectomies are only very superficial and only use tiny wounds, phlebectomy caused far less trauma to the surrounding tissue.
Therefore, for remaining varicosities, we still recommend phlebectomy at The Whiteley Clinic.
