Surgery for varicose veins may be necessary if the veins cause problems with blood flow, pain or heaviness in the legs, ulcers and other sores, blood clots or inflammation of the veins, also called phlebitis. Vein stripping surgeries are usually performed on people with severe varicose veins that result in serious health issues. Surgical techniques have been developed that include removing varicose veins through radiofrequency signals or lasers, but these work for particular cases.
Vein Stripping
Severe varicose veins develop when valves in the veins are damaged and cannot keep the blood flowing as they normally do, according to the National Institutes of Health. The veins remain filled with blood and become visible, especially when the person stands up. Surgical vein stripping may be the choice for people with large varicose veins. The surgery requires general anesthesia and takes about an hour or more to complete. It is an outpatient procedure usually performed in the hospital. No pain is felt during surgery because the patient is unconscious. There may be minor burning sensations in the areas where incisions were made following surgery.
Pulling Out
Incisions are made at the top and bottom of the damaged vein, usually in the groin and at the ankle. A thin plastic wire is inserted into the vein through the groin to the area of the other incision. The wire is then pulled out slowly from the lower cut where a small head at the tip of the wire helps in the process. It is similar to putting your hand into a sock and pulling it inside out. Hooks may also be used to pull out the vein.
Surrounding Veins
In many cases, other veins surrounding the damaged vein will also have to be removed. The surgeon will need to make more incisions. After the veins have been removed, the incisions will be closed with sutures. The patient may have to wear bandages or a compression stocking over the leg to control swelling for a few days following surgery. Some patients may need to have their legs wrapped for several weeks, depending on the severity of the vein damage.
Afterward
There may be some bruising and scarring. Pain medication and antibiotics may be prescribed. The patient will be told to rest and keep the affected leg raised whenever possible. It is usually advised that the patient take several short walks, for five or 10 minutes, during the day. Patients can increase exercise of the leg more and more as the feel comfortable with it. Most people can return to work or their normal routines within days or a couple of weeks.
Minimally Invasive Surgery
Newer procedures known as endovenous methods use radiofrequency or lasers to remove severe varicose veins for many patients. A small catheter is placed in the vein that sends out radiofrequency or lasers that shrink and close the vein wall, according to the National Women's Health Information Center. Other veins around the treated vein restore normal blood flow, and the varicose vein begins to improve. Some laser therapies can heat and destroy the blood vessels, but these work mainly on small veins. Other non-surgical methods may include sclerotherapy, which involves injecting chemical solutions to collapse the veins, and intense light therapy treatment that can get rid of some small varicose veins, the Cleveland Clinic notes.
