Ambulatory Phlebectomy

An alternative vein treatment method is ambulatory phlebectomy, also known as phlebectomy. Phlebectomy is a technique commonly utilized for larger diameter, branch varicose veins that are visible by bulging out the skin when the patient is standing. With this technique, the vein is marked with the patient standing, and then once the overlying skin and subcutaneous tissues are anesthetized, a small incision is made and a hook is inserted into the incision to hook the vein. Once the vein is hooked, the operator pulls the hook and vein out, snapping the vein, most often removing a small segment of vein in the process. This process is repeated, on average for 10 to 20 incisions per treatment session.

The disrupted veins are then compressed in a dressing that allows the vein segments to clot off, preventing continued bleeding. Alternatively, some surgeons ligate each end of the vein so that the small vein segment can be removed without allowing the remaining segments to continue to bleed. Incision sizes range from 5 cm to .5 cm and in general always involves cutting the skin, fishing out the vein, and pulling on it to break or injure the vein, and then applying pressure.

A notable finding with phlebectomy is that there is no staining, and other stigmata of prolonged inflammation as seen with sclerotherapy. Small diameter veins, such as reticular veins and spider veins are generally too small to be treated with this technique. This led the founders of VenX to seek ways to utilize ambulatory phlebectomy techniques for smaller diameter reticular and spider vein.