Please help me to understand why would I need a phlebectomy after a EVLA?
My Dr discussed EVLA and Sclerotherapy. Now, my paperwork mentions EVLA, Deep Sclerotherapy, and Phlebectomy are approved by insurance. I was told that this is just a back up procedure, but I am uncomfortable with the seemly casual addition of taking out veins.
Answers from doctors (4)
This is very common. Endovenous procedures typically treat the larger veins below the skin that you can't see. These veins often feed the visible varicose veins, and often those veins do not necessarily go away with treating the underlying vein. Therefore phlebectomy or sclerotherapy are often needed.
Published on Jul 11, 2012
In my clinic I do not inject varicose veins unless for a refluxing perforator vein. However, microphlebectomy performed in the office under local anesthetic (small punctures and removing sections of vein, no stitches) is done at the same time as the EVLA. This is the most effective way to deal with varicose veins from saphenous reflux. I certainly would express your concern to them if they haven't discussed this with you ahead of time.
Published on Jul 11, 2012
Sounds like you need to have a chat with your doctor. She/he will provide you with those answers. However, this is routine and they are just covering all the bases. In short, some physicians prefer to hold off on Phlebectomy at the time of EVLT and others(like myself) like to perform the whole thing at one sitting. Without Phlebectomy, most varicosities will subside over time, but most patients prefer them gone at one procedure.
Published on Jul 11, 2012
Ambulatory Phlebectomy can often be used in addition to EVLA and Sclerotherapy. In some cases Sclerotherapy is less successful in closing veins of large caliper and EVLA can typically only be used in veins that run a straight course. When the vein(s) to be treated are tortuous (not straight) and large in size often times phlebectomy can be a great alternative treatment.
Published on Jul 11, 2012
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