Phlebectomy: Removing Bulging Varicose Veins

Phlebectomy, also called microphlebectomy or ambulatory phlebectomy, removes bulging varicose veins through tiny 2–3 mm punctures in the skin. The punctures are so small that no stitches are needed and they usually fade to near-invisible marks. It is most often combined with EVLA or radiofrequency ablation in the same session, and every procedure at Anglia Vein Clinic is carried out by consultant vascular surgeon Mr John Prionidis PhD FRCS.

Why phlebectomy is often part of the plan

Closing the leaking trunk vein with EVLA or radiofrequency ablation treats the cause of varicose veins. Many of the visible bulges shrink afterwards, but larger ones often remain. Removing them at the same time gives a better cosmetic result straight away and avoids a second procedure.

Phlebectomy on its own may also be right for isolated varicose veins where the main trunk veins are working normally, or for veins that have returned after earlier treatment.

What happens

The veins are marked on your leg while you stand, when they are most visible.
Local anaesthetic is injected around them.
A tiny puncture is made over the vein, and a fine hook is used to draw the vein out and remove it in short segments.
The punctures are closed with adhesive strips, and a bandage and compression stocking are applied.

Phlebectomy is usually done under local anaesthetic, alongside a main procedure. If you are having general anaesthetic for your main treatment, it is done while you are asleep.

Recovery

Bruising at phlebectomy sites can look dramatic for one to three weeks, and is at its worst between days three and seven. It fades on its own and does not mean anything has gone wrong. Keep the stocking on day and night for 48 hours and walk for five to ten minutes every hour. Most people return to desk work after 48 hours and to the gym after two weeks. The full timetable is in our recovery and aftercare guide.

Risks

Bruising, tenderness and swelling — expected in almost everyone.
Temporary numbness or tingling — from irritation of small skin nerves, usually improving over weeks.
Wound infection — uncommon with punctures this small; keeping dressings dry for the first 48 hours is the best protection.
Small marks — the puncture sites usually fade to tiny, barely visible scars.

Book a consultation

Your assessment starts with a duplex ultrasound scan, done standing, to find where the leak begins. Mr Prionidis then recommends the combination of treatments that suits your leg. We see patients in Chelmsford, Bury St Edmunds and central London. No referral is needed. Call 01245 241 340 or email info@avclinic.co.uk.