• Treatment of Varicose Veins of the Leg


    This procedure involves the removal or destruction of varicose veins that are just under the skin.
    There are different methods to remove veins, such as:
    • Sclerotherapy—injects the varicose veins with a chemical to shrink the veins
    • Radiofrequency ablation—collapses and seals varicose veins using radiofrequency energy
    • Adhesive sealing—seals the affected veins that are close to the skin using an adhesive
    • Vein stripping
    • A surgical procedure called phlebectomy
    Varicose Veins
    Nucleus images
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    Veins have one-way valves to channel blood back to the heart. Varicose veins develop when the valves of the veins become damaged. This causes blood to pool in the veins, enlarging them, and often making the veins just beneath the skin visible. The skin can also turn dark purple or brown because of increased pressure.
    Treatment may be done for cosmetic and health reasons. In some cases, the areas of discolored skin may break down and form open sores, called stasis ulcers. Clots can also form in the pooled blood. When the valves are functioning poorly, your leg may burn, ache, or throb.
    Treatment for this condition can involve either destroying or removing the damaged veins.

    Possible Complications

    Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
    • Recurrence of varicose veins
    • Bleeding
    • Infection
    • Skin discoloration at the surgical site
    • A blood clot, known as deep vein thrombosis
    Smoking may increase the risk of complications

    What to Expect

    Prior to Procedure

    Your doctor will:
    • Evaluate your deep and superficial vein systems and decide which veins will be removed or destroyed
    • Do an ultrasound—a test that uses sound waves to examine the veins in your legs
    Leading up to the procedure, you may be advised to:
    • Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
    • Wear special support stockings.
    • If you have a stasis ulcer, wear Unna boots. This is a type of cast that will aid in healing the ulcer.


    The anesthesia depends on the type of procedure that you are having. Anesthesia may be:
    • General—blocks pain and keeps you asleep through the surgery
    • Epidural—numbs the area from the chest down to the legs

    Description of the Procedure

    With this procedure, a chemical will be injected into each of the damaged veins. This chemical will scar the vein so that it will no longer be able to carry blood. This will be a short, simple office procedure.
    Adhesive Sealing
    A catheter is inserted into the damaged vein. An ultrasound is used to view the placement of the catheter. An adhesive is injected into the catheter to seal the vein.
    Radiofrequency or Laser Ablation
    This is done on one of the largest superficial veins, called the great saphenous vein. The vein will be viewed using an ultrasound. Then, the vein will be punctured near the knee. A catheter will be threaded up to the groin. The space between the vein and the skin will be filled with a special solution. This solution will provide local anesthesia. The catheter will then be attached to a radiofrequency generator or a laser. Heat or light energy will seal the vein closed so that there is no longer any backflow of blood.
    Vein Stripping
    The veins will be removed by threading a long wire into them. Each vein will be tied to this wire and then stripped out. This will leave the smaller side branches broken off and in place. This procedure is usually not used on the saphenous vein.
    This surgery is used to remove larger veins that cannot be injected. Many small incisions will be made to access each varicose vein. The vein will either be tied off or removed.

    After the Procedure

    If vein stripping is done, you will have many loose vein ends in your leg. Your leg will be tightly wrapped. This is to prevent blood from leaking out of the veins.

    How Long Will It Take?

    • Sclerotherapy—short office visit
    • Adhesive sealing—short office visit
    • Radiofrequency or laser ablation—1 hour
    • Vein stripping—1-1½ hours
    • Phlebectomy—2-4 hours

    Will It Hurt?

    You will have pain and discomfort with the procedure. Stripping is more painful. Ask your doctor about pain medication.

    Post-procedure Care

    When you return home, be sure to follow your doctor's instructions. You may need to have another ultrasound done.

    Call Your Doctor

    After arriving home, contact your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
    • Pain that you cannot control with the medications you have been given
    • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
    • Cough, shortness of breath, or chest pain
    • Leg swelling
    If you think you have an emergency, call for emergency medical services right away.


    American College of Phlebology http://www.phlebology.org

    American Society of Plastic Surgeons http://www.plasticsurgery.org


    Canadian Society for Aesthetic Plastic Surgery http://www.csaps.ca

    Canadian Society for Vascular Surgery http://canadianvascular.ca


    Merchant RF, Pichot O, Closure Study Group. Long-term outcomes of endovenous radiofrequency obliteration of saphenous reflux as a treatment for superficial venous insufficiency. J Vasc Surg. 2005; 42(3):502-509.

    Varicose veins. VascularWeb website. Available at: http://www.vascularweb.org/vascularhealth/pages/varicose-veins.aspx. Accessed June 13, 2016.

    Varicose veins and spider veins fact sheet. US Office on Women's Health. Available at: http://womenshealth.gov/publications/our-publications/fact-sheet/varicose-spider-veins.html. Updated July 16, 2012. Accessed June 13, 2016.

    6/2/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

    3/16/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com: US Food and Drug Administration. FDA approves closure system to permanently treat varicose veins. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm435082.htm. Published February 20, 2015. Accessed June 13, 2016.

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