Here’s Why Vein Stripping is Outdated

Vein stripping, sometimes called high ligation and stripping, is an old treatment for varicose veins. Once considered the standard treatment, the procedure has changed and…

doctor examines varicose veins

Vein stripping, sometimes called high ligation and stripping, is an old treatment for varicose veins. Once considered the standard treatment, the procedure has changed and improved with new techniques and devices, but it’s rarely used now.

Vein stripping is an expensive, invasive surgery linked to longer recovery and varicose vein recurrence. With new technologies, the latest treatments for varicose veins are just as effective or better than surgery. These treatments can be performed right in your doctor’s office without the need for hospitalization. 

What Is Vein Stripping?

Vein stripping is a surgical procedure used to treat varicose veins. Varicose veins occur when high blood pressure weakens the valves in your veins, usually in the leg. This causes blood to pool, leading to swollen, raised veins and sometimes pain.

Vein surgery involves an incision in the groin to remove the swollen vein. The first step is to tie off the vein and any damaged smaller veins.

Next, the vein is cut and pulled out through the incision in the leg, removing the vein all the way to the knee or lower leg. This method of vein removal is called stripping.

Is Vein Stripping Outdated?

Yes. Occasionally, vein stripping surgery might still be recommended, but such cases are rare. Vein stripping is an invasive procedure as it is an open surgery and involves fully removing veins. 

While the surgery is considered low-risk, it still requires sedation. There are risks with any procedure, but going under general anesthetic raises your chances for serious complications. 

Additionally, there are other risks, complications, and drawbacks that come with the procedure, including:

  • Potential for nerve injury
  • Scarring from incisions 
  • Varicose veins often come back
  • Longer recovery
  • Requires hospital stay
  • Potential for infection
  • Expensive treatment

Considering these factors, other treatments are preferred.

Best Treatments for Varicose Veins

Over the last decade or more, vein stripping has been replaced with more advanced varicose veins treatments that have excellent outcomes and fewer complications. These include:

  • Varicose vein laser treatments
  • Medical adhesive treatments
  • Vein irritant treatments

While not necessarily advanced, gradient compression stockings are also one of the most effective varicose veins treatments. 

Endovenous Laser Ablation

Endovenous laser ablation is a minimally invasive procedure that uses heat to close off the vein. This procedure is conducted inside the vein. Your doctor inserts a laser through a catheter and applies heat to the wall of the varicose vein. As a result, the vein narrows, scars, and eventually disappears. 

Studies show that up to 50% of people who undergo vein stripping surgery experience vein regrowth in the same area. However, when these veins grow back, they don’t have valves, which can cause recurring and worsened varicose veins. 

In contrast, 85% of people treated with endovenous laser ablation still have permanent vein closure five years after the procedure. This success rate makes EVLA treatment significantly more effective than vein removal surgery.

Endovenous laser ablation can also be done in a clinic with only a local anesthetic, which means there’s no general sedation. Recovery times are short and you’ll be able to return home following the procedure.

Although rare, possible side effects of EVLA include:

  • Pain
  • Skin burn
  • Skin hyperpigmentation

Cyanoacrylate Varicose Vein Treatment

Cyanoacrylate is a medical glue that is injected into the vein under ultrasound guidance. The glue seals the varicose vein and causes inflammation and blockage. Eventually, the vein scars and becomes permanently closed.

Where laser treatment might cause pain and burns, the benefit of cyanoacrylate treatment is that it is virtually painless. It can even be done without anesthesia.

Several studies show that cyanoacrylate is a highly effective treatment. After 12 months, 90% of patients have permanently closed veins, which suggests that it’s just as effective as endovenous laser ablation.

The procedure itself is simple and well-tolerated. Side effects are possible but are usually mild and can include:

  • Mild pain, itching, or redness after the procedure
  • Swelling
  • Skin hyperpigmentation

Microfoam Injection for Varicose Veins

Microfoam injections are a type of sclerotherapy treatment for varicose veins. This procedure involves injecting a foam solution into the vein under ultrasound guidance. This foam acts as an irritant, which causes inflammation, blood clotting and displacement, and narrowing of the vein wall. Eventually, this leads to blockages, scarring, and permanent vein closure. 

To treat varicose veins with microfoam, you might need a couple of injections. Studies show that with an average of two injections, 100% of patients felt their legs were successfully treated, 85% felt complete relief from all their symptoms, and 92% had completely resolved varicose veins. 

Microfoam injections are painless and don’t require anesthesia. Cases of allergic reactions are low, though they can occur. Other side effects can include hyperpigmentation or skin discoloration. 

Ambulatory Phlebectomy

Sometimes called a stab phlebectomy, ambulatory phlebectomy is a treatment for smaller varicose veins. In this procedure, a doctor makes tiny punctures in the skin and pulls a vein until it naturally breaks or is removed. They then make another incision and repeat the process until the veins are removed. 

Patients only need numbing medicine on the areas where the doctor makes an incision. This process is called an ambulatory phlebectomy because it’s an outpatient procedure (meaning patients can go home the same day) and requires minimal recovery time. 

This procedure has very little downtime. You won’t need any stitches as the skin will close up on its own, keeping scarring to a minimum. 

Find a Vein Specialist Near You 

Varicose veins and spider veins can interfere with your life and cause personal stress. It’s important to talk to a vein specialist about the best varicose veins treatment for your unique situation. Try My Vein Treatment physician locator today to find a specialist near you. 

SOURCES:

  1. Balint, R., Farics, A., Parti, K., Vizsy, L., Batorfi, J., Menyhei, G., & Balint, I. B. (2016). Which endovenous ablation method does offer a better long-term technical success in the treatment of the incompetent great saphenous vein? Review. Vascular, 24(6), 649–657.
  2. Barret, John M., Allen, Bruce., Ockelford, Anne., Goldman, Mitchell. (2004). Microfoam Ultrasound-Guided Sclerotherapy of Varicose Veins in 100 Legs. Dermatologic Surgery, 30:1, 6-12
  3. Bootun, R., & Davies, A. H. (2016). Long-term follow-up for different varicose vein therapies: is surgery still the best?. Phlebology, 31(1 Suppl), 125–129. 
  4. Khilnani, Neil. (2020). Varicose Vein Treatment With Endovenous Laser Therapy. Medscape.com Accessed 19 August 2021.
  5. Langridge, B. J., Onida, S., Weir, J., Moore, H., Lane, T. R., & Davies, A. H. (2020). Cyanoacrylate glue embolisation for varicose veins – A novel complication. Phlebology, 35(7), 520–523. 
  6. Lew, Wesley. (2021). Varicose Vein Surgery. Medscape.com. Accessed 19 August 2021.
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