Physician and laboratory evaluations are performed at our office location at 7th and Spruce Streets. Most procedures, including those requiring local anesthesia, are performed on site in the office setting as well. Major vein stripping requiring general anesthesia is performed at Pennsylvania Hospital.
A minimally invasive, local anesthesia alternative to vein stripping surgery that is performed in the office. Learn more.
Ambulatory phlebectomy (Microphlebectomy)
This office-based procedure is appropriate for secondary varicosities that persist after treating saphenous reflux, or for varicosities not contiguous with a major refluxing vein. Using a dilute anesthetic solution, small (-3mm) stab incisions are made over the bulging veins, and specialized hooks and clamps tease the veins out. The small incisions do not require suturing and heal with minimal scarring. Moderate bruising and discomfort is typical, and compression therapy is used for several weeks.
This office based modality is optimal for veins too small for phlebectomy, such as spider veins and reticular veins. No anesthesia is needed, and the procedure is nearly painless. A solution containing an agent irritating to the vein lining is injected under magnification. The inflammatory response incites a localized phlebitis within the tiny veins causing them to close.
The small amounts of clotted blood may leave brownish pigment in the area, which typically resolves over a few months. Sometimes this material is drained with a small needle to accelerate healing. Several treatment sessions are usually needed for optimal cosmetic results.
Eversion vein stripping
The traditional treatment for reflux from the greater saphenous vein (the most common cause of large varicose veins) has been surgical removal. Under general or spinal anesthesia, incisions are made at the groin and below the knee, and a wire is passed through the vein. A “bullet” is attached to the end of the wire and pulled back, tearing the vein from its branches and subcutaneous tissue. Bleeding into the space from which the vein was removed is minimized by compression, but significant bruising and swelling are common. This generally resolves within six weeks. Ace wrapping or support stocking are needed for two to six weeks.
Graded compression stockings
As standing and having the legs in a dependent position increases the pressure in the leg veins, leg elevation will often relieve symptoms. To counteract the high pressure gradient in the standing position, elastic support hose can be quite effective. These stockings keep the veins collapsed and prevent reflux, and may help prevent progression of varicose veins. They can be used as definitive therapy or in conjunction with other treatments.