Microphlebectomy, or ambulatory phlebectomy, is a type of outpatient varicose vein treatment where a varicose vein, or a section of it, is removed. This procedure is most often performed on a larger superficial vein that is bulging out under the skin, i.e. you can actually feel the vein through the skin as you run your finger over it.
During microphlebectomy varicose vein treatment, a series very small incisions, usually only three to five millimeters long, are made in the skin along the path of the vein to be removed. Your skin will be pre-marked before they do the incisions and a duplex ultrasound will guide the doctor in knowing where to make them. A hook tool is then used to gently remove the varicose vein one tiny section at a time by gentle tugging.
Unfortunately, sensory nerves can run very close to veins, especially if there is inflammation. Certain areas of the leg have more nerves. The area below the mid calf, especially around the ankle and on the foot, has many sensory nerves. Veins also tend to run close to the veins in this area as the skin is thin. Edema and inflammation around the ankles can also put the nerves closer to the veins.
Vein doctors do spend time searching for these nerves and try to avoid them. However, when sensory nerves are located so close to the veins, they do sometimes get stretched or otherwise damaged during microphlebectomy when small segments of the vein are being pulled out. When this happens, some patients experience a shooting pain or stinging sensation during the procedure. They may experience other symptoms after the procedure (see blow). Thankfully, motor nerves, those nerves that control muscle movement, don’t usually run next to veins.
The symptoms of nerve damage vary after an ambulatory phlebectomy varicose vein treatment. The most common symptoms are numbness and or a tingling sensation. Some people with nerve damage may experience burning and stinging, at least temporarily. However, unless the damaged nerve was actually cut, which is rare during a microphlebectomy and most modern varicose vein treatment, these symptoms are not usually permanent. You should know too that your vein doctor and your written medical report(s) may refer to these types of symptoms collectively as “neuropathy” even if you report numbness, tingling, burning, etc.
Most stretched or otherwise damaged nerves do heal in time, unless they are completely severed. However, nerves are notorious for healing SLOWLY. Therefore, you’ll need to be patient because it may take a while for your symptoms to go away. Although these symptoms can be distracting, or even painful, it’s best to put “mind over matter” and just give your body a chance to heal. Yoga and other forms of meditation can help. Simple things like aromatherapy and listening to your favorite music can also help take your mind off the irritation.
If you experience symptoms of nerve damage after a microphlebectomy varicose vein treatment, in most cases it will disappear on its own within six to twelve months. However, there are a few things you can do to speed up the healing process and give relief by desensitizing the damaged nerves:
1. Massage the affected area with your fingers using light pressure. Be careful not to press too hard and don’t use an electrical massager.
2. Stretch the area. In some cases, walking is enough to stretch the area. In other cases, you may need to do light stretching exercises. A single session with a physical therapist can teach you some specific stretches that will help. Talk with your vein doctor for a referral as this will increase the odds your insurance will pay for the session with a physical therapist.
3. Apply MILD heat. Many electrical heating pads get too hot, even on the lowest setting. Try a microwave heating pad instead and allow it to cool before applying it. You can also apply a warm wet hand towel periodically.
4. Wear compression stockings. This will apply gentle pressure to the affected nerve and may help ease the irritation.
You can reduce the possibility of nerve damage when you have microphlebectomy varicose vein treatment if your vein doctor has exceptionally skilled hands and is highly experienced. You’ll find vein doctors in this category at Metro Vein Centers, a well respected varicose vein treatment clinic with multiple locations in the United States. If you have bulging varicose veins. and you want to determine if microphlebectomy would be the best option for your varicose vein(s), you can schedule a free evaluation at Metro Vein Centers just by giving them a call.
