What is microphlebectomy?

Microphlebectomy, also known as ambulatory phlebectomy, is a method of removing veins on the surface of the legs through very small incisions which frequently will require no stitches or at most only one and rarely two stitches.  Since veins are very collapsible, large veins can be removed through these tiny incisions.

Why are microphlebectomies done?

Performed on an outpatient basis, microphlebectomy treats veins that are visible on and close to the surface of the skin, and is an excellent option if the problem veins are too large to be effectively treated with other procedures like sclerotherapy.  Large veins treated with sclerotherapy can be painful for quite some time but not with microphlebectomy.

Microphlebectomies are used most commonly after endovenous laser ablation to remove remaining large ropey branches of saphenous vein or perforating veins.  At the beginning of endovenous laser and under duplex guidance or with you standing, the veins for microphlebectomy will be mapped and the skin over the areas for microphlebectomies marked.  The incision is made with a needle or small blade.  The results are much more acceptable to the patient because of little or no scaring and they heal quickly.

Microphlebectomies stop the flow of blood into malfunctioning veins.  The sections that are not removed then clot and seal off resulting in blood flowing through nearby healthy veins rather than those that were causing discomfort and discoloration.

How does microphlebectomy compare to similar procedures?

When compared to similar procedures, microphlebectomies offer some positive advantages in that they are:

  • Minimally invasive
  • Require only local anesthesia
  • May be used in combination with endovenous laser or sclerotherapy for treatment of larger remaining veins that originate from the great saphenous or small saphenous veins and were treated with laser.
  • Require little to no recovery time so patients are back to their daily activities with little or no downtime

Who should consider microphlebectomy?

Individuals who desire treatment for their painful or unattractive varicose veins or spider veins may be candidates for microphlebectomy.  Your doctor will review with you if this is the best alternative for you and you are encouraged to ask any and all questions you may have.

If a patient has a vascular condition or is pregnant, this procedure may not be for them.

What should I expect after the procedure?

When done as a stand-alone procedure, a short recovery time is one of the benefits of microphlebectomy, especially compared to that of traditional surgical procedures.  The majority of patients resume their daily activities right after treatment, although they are encouraged to refrain from physically demanding activity for a week or so.  Compression stockings are often recommended for the week following the procedure to hasten the healing process.  Since the incisions made are very small, most patients experience almost no scarring.

Are there any risks involved?

Side-effects are typically mild and short-lived, but could include mild discomfort and bruising immediately following the procedure.  On rare occasion, some patients experience slight damage to the tiny, superficial nerves near the treatment site, but these ordinarily heal in time.

Will my insurance cover the cost of treatment?

Microphlebectomy is typically considered a cosmetic treatment and so is not covered by insurance.  However, if the treatment is for veins that are compromising the patient’s health or well-being, the procedure may be covered to an extent and especially if they are large and remain painful.

When done in conjunction with endovenous laser, most insurance companies have begun to delay permission to do microphlebectomies until it is seen if the symptomatic veins resolve over a period of weeks.  In these instances, permission is again requested if the veins continue to be symptomatic.

It is best to discuss your personal coverage with your insurance representative.  At the Vascular Center of Wichita Falls, we will work with you and your insurance company in seeking approval when medically necessary.


We hope the information on these pages is both informative and helpful, but it is intended for education only.  Please do note that no web site, no matter how much information is shared, can replace a consultation with your doctor and a vascular specialist.  Medical technology and treatment are continually improving and evolving so before making any decision on treatment, it is always advisable to see your doctor first for a comprehensive evaluation of your vascular disease and other medical conditions.

At the Vascular Center of Wichita Falls, we work closely with your other physicians.  If you have concerns about your arteries or veins, contact us.  A referral is not necessary to make an appointment.