Ambulatory Phlebectomy (AP)
An Ambulatory Phlebectomy is for the treatment of the bulging and superficial varicose veins.
Ambulatory phlebectomy, also called “microphlebectomy”, is a mini-surgical treatment used to treat superficial varicose veins and their branches.
Before the actual procedure, the area around the bulging vein is injected with local anesthesia. Next, multiple tiny incisions are made in the skin’s surface. These incisions are normally between 2 to 3 mm, small enough to reduce risk of scarring and not cause a lot of pain.
The target veins will be marked while you’re in standing position. Then, you will be asked to lie down on an operating table, and be given local anesthesia. Through the incisions, the abnormal vein will be extracted using a phlebectomy hock or a vein retractor.
There two steps to grasp the vein:
1.) by grasping the vein using sharp instrument, e.i phlebectomy hook
2.) by winding around the vein using a blunt instrument, e.i vein retractor
The phlebectomy hook grasps the vein through the incisions, and then the vein doctor will slowly extract and clamp it. Next, the vein is slowly pulled out.
Ambulatory phlebectomy may be an outpatient procedure but it still requires extreme precision, like that of Vein Institute of Pinellas.
What is treated by Ambulatory Phlebectomy?
Ambulatory Phlebectomy is a minimally invasive procedure that is generally used for veins bulge at the skin surface. This should be considered if the varicose vein is too large for sclerotherapy, but too small for laser ablation.
Why people choose Ambulatory Phlebectomy?
Varicose veins can cause a burning/throbbing sensation, heaviness, and itching in the legs. They are also bulged and discolored, which one might find visually unpleasant.
While there are many other vein treatments out there, ambulatory phlebectomy is opted by many because it is minimally invasive. Only tiny incisions are needed to access the problematic vein. And with the precision of the vein experts of Vein Institute of Pinellas, risk of scarring is reduced significantly.
This procedure has a relatively short downtime. In fact, you can go back to work right after the procedure. Although you must avoid laborious work.
Individuals who want to get rid of bulging veins right away should consider ambulatory phlebectomy. This is because sclerosant or any other conservative measure may not be enough to shrink them.
Who is a good candidate for Ambulatory Phlebectomy?
It is suggested to schedule an appointment with Vein Institute of Pinellas so we can evaluate your varicose veins thoroughly and formulate the best treatment plan for you.
Anybody who wants to remove bulging troubled veins may consider this treatment. But before we proceed, the following has to be accomplished first:
- A meticulous evaluation of your medical history and physical exam
- A detailed assessment of your legs
- Diagnostic ultrasound
- Photos of the varicosities for the insurance provider and for recording purposes
- Detailed explanation of the procedure, expectations, and outcome
- Evaluation of possible risks
Our vein specialist will also consider the possibility that the varicose vein is caused by another problem. The veins will also be checked for clots because these can be dangerous.
It is important to know that there you may be required to undergo additional procedures to achieve desired results.
Why is an ultrasound required?
An ultrasound is required before any vein treatment to monitor the blood flow throughout the legs. The result of the ultrasound is crucial for the vein doctors of Vein Institute of Pinellas to determine the best procedure or combination of procedures for you.
Why should you choose ambulatory phlebectomy for your varicose veins?
Ambulatory phlebectomy may be considered in the treatment of symptomatic and asymptomatic superficial veins. Usually, it is used for larger varicose veins that bulge above the skin surface. Smaller veins are usually treated using laser ablation.
For venous disease, ambulatory phlebectomy may be used in conjunction with other procedures. The vein specialists at Vein Institute are highly-trained in different vein treatments, so they can easily figure which treatments goes best with another based on the unique condition of the patient.
Individuals who cannot walk on their own or wear compression stockings are not suitable for this procedure.
How to prepare for an ambulatory phlebectomy?
After the vein specialist has approved your ambulatory phlebectomy, it is important to adjust some of your activities because of the following:
- The procedure can take 1.5 to 2 hours. If both legs are to be treated, you need to multiply those numbers by two.
- Prepare your compression stockings. You will have to wear these to assist fast recovery and prevent complications.
- You will be asked to sign consent forms.
- It is advised to avoid coffee, soda, or any caffeinated or high-sugar drink for they can cause the vein to constrict.
- Alcohol consumption should be avoided at least 48 hours before the procedure. This is because alcohol has wide effects on the body. It can also raise your anxiety and make you more uncomfortable during the procedure.
What happens during the procedure?
- After completing the consent forms, you will be asked to to put on a more comfortable clothing.
- You will be asked to stand up while our vein specialist marks the abnormal veins. This is because they are most apparent when you are in a standing position.
- The marked areas will be discussed with you. Our medical assistant may have to update your information if needed.
- The area to be treated will be cleaned in a sterile-fashion and then draped to prevent infections.
- Local anesthesia will be injected into the area around the vein.
- Once the anesthesia takes effect, the vein doctor will make tiny incisions near the vein.
- The vein doctor will extract the problematic vein through the incisions.
- After extraction, the incisions will be closed using wound closure strips.
- You will be assisted in putting on the compression stockings.
We understand that, though ambulatory phlebectomy is minimally invasive, it can still put some stress the patient. This is why we give them time to rest after the procedure.
What happens after the procedure?
- Immediately after the procedure, you will be give home care instructions and prescriptions. Your follow up appointment will be also be confirmed.
- Do not drive on your way home, even if you did not take anti-anxiety medications. Arrange for a friend or relative to take you home after the procedure.
- Most of your normal daily activities can be resumed except those that require heavy lifting or any physically strenuous activity.
- Relax and elevate your legs for 15 to 20 minutes per day.
- The compression stockings are required for several days. After ambulatory phlebectomy, two wraps should be worn over the treated area. You may remove the top wrap 6 hours after the procedure, and the bottom wrap after 3 days.
- The compression wraps must be kept dry and clean to avoid infection.
- It is only normal to experience redness, warmth, and bruising in the treated area. These usually goes away within two weeks.
- Small bumps beneath the extraction site are also common. These are trapped blood or scar tissues, which naturally dissolve within few weeks.
- You have to come back for a follow up checkup 5 to 7 days after the procedure.
- No are no diet restrictions. But it is advised to consume ample fruits and vegetables.
What should you do in case of bleeding?
Bleeding may occur after the wrap is removed. Do not panic and follow the instructions:
For small amount of bleeding (size of a stamp), simply apply pressure for at least 30 minutes and elevate your legs. This is normal.
For moderate bleeding (larger than two inches), add another layer of gauze over the existing gauze, and secure them well. Elevate your legs at least 45 degrees so blood doesn’t accumulate in the vein. You can do this by lying on the floor with your legs against the wall. Then, apply pressure over the incision site to allow proper blood clotting.
If the bleeding doesn’t stop, call us. The Vein Institute of Pinellas is willing to extend as much assistance as possible.
Can you shower after ambulatory phlebectomy?
You may shower 36 to 48 hours after the procedure. Put on plastic protector around the compression wrap to protect it from moisture.
Do not remove or scrub over the wound closure strips. They will fall off on their own as your wounds heal. Pat the strips dry after bath.
Avoid hot tubs and saunas while your leg is still recovering.
What if you have many varicose veins?
Ambulatory phlebectomy requires the total concentration on the part of the vein surgeon. This is because the instruments are fine-tip and the veins are thin.
Only 10-20 segments can be removed at a time. This means, patients with many varicose veins need several sessions.
The number of treatments and the extent of veins to be removed will be determined during your first clinical visit.
How Much Does Ambulatory Phlebectomy Cost?
Varicose veins are not only unsightly; they can also cause discomfort and restlessness.
The cost of an ambulatory phlebectomy may vary depending on the extent of the vein to be extracted and the number of sessions. Thankfully, most insurance providers cover treatments for vein problems. However, there may be several requirements to avail the coverage.
Many insurance providers approve this type of treatment if the patient didn’t respond to more conservative measures. These include oral medications, sclerotherapy, and wearing compression stockings. Being unable to take anti-steroidal inflammatory drugs (NSAIDs) can help you get a coverage.
Why patients choose Vein Institute of Pinellas?
Vein Institute of Pinellas proudly offers services that are founded on integrity. We communicate with our patients directly and honestly particularly when talking about the possible outcomes, risks, and cost.
This way we are able to minimize the inconveniences because both parties are working together, us and the patient.
Our vein doctors are fully-licensed, widely-experienced, and knowledgeable about vein problems and their treatments.
They understand the struggles of having varicose veins. This is why they go above and beyond to treat varicosities as minimally invasive as possible.
You must also feel comfortable discussing your vein problem with them because such information can be helpful in planning out your treatment plan.
From manual tools to machineries, we use the most advanced from the most trusted brands. This is to ensure accurate and timely diagnostics and treatment. Our facility is one of the most sophisticated ones in the country.
Using ultrasound technology and sharp clinical eye, we examine each patient thoroughly so as not to miss any problem.
Through this, we are able to help numerous patients live comfortably and free from varicose veins.
We have facilities in Largo, Sun City Center, and St. Petersburg to provide high-quality vein treatment to the Bay Area.
All of these facilities are equally competent.
Extended Office Hours
We understand that many are only able to visit the doctor after work or school. This is why we extend appointment after normal office hours.
Call us or book an appointment through our website.
Covered by Medicare
Vein Institute of Pinellas accepts Medicare and many other insurance providers. However, we would recommend that you discuss your vein problem with them before undertaking the treatment. This is to be informed of the extent of the coverage.
We know how important privacy is to a person.
All records are sealed and never opened without the permission of the patient or the order of the law. Our staff also never discusses the case or any personal information of a patient with a third party.
Cleanliness and Sanitation
As a professional vein treatment facility, it is one of our priorities to keep our surroundings clean, sterile, and organized at all times.
All our tools are also properly sterilized before and after any procedure.
Licensed and Safe
All of our facilities have been inspected and approved by relevant regulatory bodies. We also ensure that we have the required safety devices and fire exits.