| Subject | Contents |
| Definition | Surgery to remove or treat enlarged (dilated) and/or twisted (tortuous) veins ( varicose veins ).
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| Alternative Names | Vein stripping; Sclerotherapy of veins |
| Description | Varicose veins usually occur in the legs. The valves in the veins become damaged or are absent and the veins remain filled with blood, especially when standing. The varicose veins can be treated by removing them (vein stripping) or by injection with a substance that causes the veins to scar closed (sclerotherapy). Removing or treating varicose veins does not cause circulation problems because veins can re-route themselves (collateral circulation) around a blockage.
Vein stripping is done while the patient is unconscious and pain-free (general anesthesia). Incisions are made at the bottom (ankle end) and at the top (groin end) of the varicose vein. A thin wire like instrument is inserted into the vein that removes (strips) the vein from the inside. Small incisions can also be made over the veins to remove them.
Vein sclerotherapy is done while the patient is standing. A substance that causes scarring (sclerosing agent) is injected into each varicose vein. An elastic bandage is wrapped snugly around the legs.
Many times, both procedures are performed; some of the veins are stripped and some are sclerosed. |
| Indications | Varicose vein surgery may be recommended for:
varicose veins that cause circulatory problems ( venous insufficiency ) skin irritation and sores ( ulcers )blood clots in the veins ( phlebitis ) which can travel to the heart, lungs, or brain ( embolism ) cosmetic purposes |
| Risks | Risks for any anesthesia are:
reactions to medications problems breathing
Risks for any surgery are:
bleeding infection
Additional risks include:
blood clots (call your doctor if your feet become cold or change color) irritation of the vein from the sclerosing solution the sclerosing solution can obstruct blood flow leakage of the sclerosing solution out of the veins into other tissue (it can damage the surrounding tissue) hematomas (bruises) nerve injury |
| Expectations after surgery | The majority of patients (over 85%) who have undergone this surgery have good results. It is important that feet are kept raised above the heart whenever possible, if you are prone to varicose veins. Losing a few veins has little consequence since the remaining deeper veins can take over by stretching their walls, holding larger volumes, and opening collateral pathways. This adaptation process can sometimes lead to more varicose veins and which may require repeat surgeries in 30% of cases.
The outcome is good in about two-thirds of the patients who undergo sclerotherapy. In one-third of the patients, however, inflammation with rupture of blood flow and skin discoloration are persistent for several months following surgery.
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| Convalescence | A hospital stay may not be required. After surgery, the legs are wrapped tightly in bandages. Walking is possible the first day after surgery and is recommended to minimize swelling and avoid the risk of deep venous thrombosis . It is important that feet are kept raised above the heart whenever possible. |
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