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Ambulatory Phlebectomy

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Ambulatory Phlebectomy


Ambulatory phlebectomy is a procedure to remove large superficial varicose veins through tiny incisions. An alternative to typical vein stripping surgery, this minimally invasive procedure can be used to remove the dilated veins in the legs.

Perfect vein surgery option for unsightly and uncomfortable veins. 

Varicose veins result from a variety of factors including prolonged standing, heredity, and pregnancy. While some varicose veins are asymptomatic, many result in swelling of the lower legs and feet, leg cramps, and occasionally a breakdown of the overlying skin called stasis ulcers

Treatment for varicose veins ranges from conservative, non-invasive approaches such as exercise and compression hose to surgical vein stripping under general anesthesia. 

Due to the reduction in anesthesia and small incision size, these procedures can be performed in the physician's office or in an outpatient surgery center.

Ambulatory Phlebectomy


Ambulatory phlebectomy begins with the patient standing since this is the position where the varicose veins are most easily identified. The veins to be removed are marked with a surgical marker. 

Then with the patient supine, the leg is prepared with an antiseptic solution and local anesthetic is injected along the veins to be treated. 

A common anesthetic used with this procedure is a large volume of a low concentration local anesthetic. The fluid not only numbs the surrounding area for the ambulatory phlebectomy procedure, but it helps to pull the veins away from the adjacent tissue and compresses the surrounding capillaries to reduce post procedure bleeding.

Once the entire area to be treated has been injected with the anesthetic solution, tiny incisions are made over the veins, which can then be removed using vein hooks. The incisions for ambulatory phlebectomy procedures are so small they do not require sutures.

 These incisions allow the excess fluid to drain post operatively. When all the veins targeted for treatment on one leg have been completely removed, pads to absorb the fluid are placed next to the skin and the leg is wrapped tightly in a compression bandage.


Complications can occur with any procedure, the most common being bleeding or infection. With the small incisions used for ambulatory phlebectomy these complications are much less common than with traditional vein stripping. Typically the incisions heal without scarring. Darker skinned individuals may require more time for these areas to fade. Other postoperative problems which typically resolve are discoloration of the surrounding skin, numbness, and tingling. With any treatment procedure long term recurrence of varicose veins can occur, especially if the same factors causing them remain following treatment.


The cost of an ambulatory phlebectomy depends on the extent of the varicose veins to be treated. Insurance often covers the cost of treatment but may require more conservative options such as compression hose, weight loss, and exercise be initiated first before surgical therapy is undertaken. Since each patient is different, consultation and evaluation by a physician experienced in ambulatory phlebectomy is the best way to determine if this procedure is appropriate.


Sclerotherapy is often used to treat varicose and spider veins. Using a tiny needle, veins are injected with a solution that irritates the lining of the vein wall, causing them to collapse and gradually fade away. This procedure is performed in office, usually lasting approximately 30-60 minutes. Multiple treatments may be needed to reach desired results. For optimal results, reticular veins associated with spider veins also need to be sclerosed. Compression stockings are worn for about one week post procedure. Most patients resume normal activities immediately. An allergic reaction to a sclerosant is rare, but has been reported. Staining, or brown discoloration on the skin is a possible side effect of sclerotherapy. This staining may take six months or longer to fade. Rarely sclerotherapy may result in the breakdown of a small area of skin resulting in an open wound (an ulcer). Some patients may develop lace-like matted webs of tiny, dilated, red, blue, or purple capillaries, arterioles, or venules visible just below the skin surface after sclerotherapy. Despite appropriate treatment, spider veins may recur later in life, possibly due to the underlying genetic predisposition that led to the development of spider veins in the first place. Treating spider veins does not keep new ones from appearing, but treating new ones every few years may be appropriate to keep them from becoming too extensive. After childbearing years, which are associated with hormonal swings, spider veins may develop more slowly.

Meet Dr. Chris Malcom

Call (208) 454-4976

While Dr. Malcom treats a variety of patients, he also specializes in the treatment of vein disease in women, including those with pregnancy and post-pregnancy needing sclerotherapy or other vein surgery. He is one of the lead trainers, ensuring all vein doctors are able to carry out care at a high level but affordable price.

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Dr. Chris Malcom Idaho
Call to See If You Qualify For a Free Consultation! 208-454-4976

Patient Testimonials

mary knuth
Mary Knuth

I was skeptical they could help me, but the staff is professional, thorough, knowledgeable and they explained ALL aspects of my treatment options. I would not hesitate to recommend "Vein Center" to anyone.

steve gates
Steve Gates

Very professional staff. Willing to go above and beyond for their patients. Would recommend to anyone.

Terri L Cates Patton
Terri L Cates Patton

My legs have never looked so good! Dr. Joe is great, he performed phlebectomies, one on each leg and it was a minimal invasive procedure. Back to work the next day with very minor pain if any at all. And 2 treatments of sclerotherapy. Would definitely recommend.

LaRae Saxton
LaRae Saxton

They really take care of you. They answered all my questions. They are very caring. I recommend them whole heartedly!

Our Reviews


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Premier Vein Specialists

Left untreated varicose veins can lead to major complications- pain, clots, or swelling leg veins. Lose your veins and find your smile with The Vascular Institute.



Sсlеrоthеrару іѕ a mеdісаl рrосеdurе thаt involves thе іnjесtіоn оf a solution саllеd thе sclerosant іntо a vеіn tо соmрlеtеlу оblіtеrаtе іt.

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Radiofrequency Ablаtіоn (RFA) is a tесhnіquе that uѕеѕ thеrmаl (hеаt based) energy to dаmаgе thе vеіn, rеѕultіng in thе іmmеdіаtе сlоѕurе of the vеіn.

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Also known as the VNUS Closure Procedure, it offers an efficient, non-surgical alternative for treating varicose veins using RF Energy.

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