Vein ligation and stripping are two surgical procedures used for the treatment of varicose veins, which are large, swollen surface veins that usually occur in the legs. Stripping and ligation have been standard procedures for varicose veins since the early 20th century with only a few changes. However, due to newer, non-surgical treatments of varicose veins, fewer doctors today perform vein stripping surgeries.
In any case, varicose veins and their various treatments are highly individualistic, and a doctor should always be consulted as to which is the best treatment for you.
Who is and isn't a candidate for vein surgery?
Vein ligation and stripping are suggested for larger varicose veins. For smaller varicose veins or spider veins, sclerotherapy may be a better option.
You may not be a good candidate for vein surgery if you:
- Are pregnant
- Have a history of poor circulation in the legs
- Have blockage in the deep venous system
- Have swelling related to lymph blockage
- Have recurrent incompetence after a previous surgery
- Are older and for whom any type of surgery is not recommended
What happens during vein stripping and ligation procedures?
Vein ligation and stripping are both performed by a specialist in a clinical setting, and are often performed together. For less severe cases, vein ligation is performed alone.
In vein ligation, a local anesthetic is applied before making small incisions along the problem vein, which is then tied off at the faulty valve. Since the problem areas are tied off but the healthy vein is left intact, blood flow then redirects itself to the healthy portion of the vein.
In vein stripping, a local or general anesthetic is applied before making two incisions along the leg, one near the groin and one near the knee. After these incisions are made, the two ends of the faulty vein are snipped and tied off. The surgeon will then feed a stripping wire along the length of the vein and will proceed to remove the vein, which is known as stripping the vein. This allows the blood flow to redirect itself to healthier passages, while the problem passage is removed entirely.
What is the recovery period like?
You can return home the same day the procedure is performed. People are usually able to return to work and other regular activities within a few days. Compression stockings will need to be worn for the following two weeks—24 hours a day for the first week and only during the day for the second week. More time may be required at the suggestion of your doctor. Pain medication may also be prescribed for the following few weeks.
What are the results and risks of vein ligation and stripping?
Most patients experience immediate and long-lasting relief from the pain associated with varicose veins, as well as improved appearance of their legs.
Risks associated with vein ligation and stripping include scarring and the return of varicose veins. If there is also damage to the deep vein system of the legs, these procedures can increase problems with blood flow, which is why a full diagnostic examination with ultrasound mapping is an important step in determining if vein ligation and stripping is right for you.
Additional risks with vein ligation and stripping include the usual risks associated with any type of surgery, such as infection or bleeding.
What are alternatives to vein stripping and ligation?
A newer procedure known as endovenous ablation has gradually come into popular use. This procedure involves making a single needle point into the leg rather than incisions. A laser or thermal fiber is then fed through the faulty vein. The laser then heats the lining of the vein as it is pulled out, causing the vein to collapse, shrink, and eventually disappear. Studies have shown that this procedure leaves a less noticeable scar, lets patients return to work more quickly, and has fewer post-operative complications.
Is vein surgery covered by insurance companies?
Vein ligation and stripping may be covered by medical insurance if the procedures are considered medically necessary, such as when patients experience painful symptoms. If patients pursue vein surgery solely for cosmetic purposes, it is generally not covered by medical insurance.
How much does vein surgery cost?
A number of factors influence the cost of vein surgery, including the combination of procedures required, geographical location, surgeon’s fees, and the number of veins to be treated. To confirm the cost of receiving vein ligation and stripping in your area, contact a local vein specialist to schedule a consultation.
Reviewed February 3, 2017
FAQs
Overview. Vein ligation and stripping is a minor surgery. It is used to remove a damaged vein and prevent complications of vein damage. If several valves in a vein and the vein itself are heavily damaged, the vein (or the diseased part of the vein) is removed (stripped).
What is the difference between vein ligation and vein stripping? ›
The doctor will make small cuts in the area and then tie off (ligation) and remove the vein (stripping).
What is the recovery time for vein stripping? ›
Most people will be able to walk around within a few hours after their surgery. However, you will need to keep your legs elevated as much as possible for three to four days after surgery. As your legs heal over the next two to four weeks, continue to keep your legs elevated as much as possible while sitting down.
What happens after vein ligation? ›
Your Recovery
You can expect your leg to be very bruised at first. This is a normal part of recovery and may last 2 to 3 weeks. You may wear compression bandages or stockings on your leg for at least the first few days after surgery. This can help reduce bruising.
What are the complications of high ligation and vein stripping? ›
Blood clot in your leg. Infection at the site of your incisions. Irritation of a nerve near the removed vein, which can cause numbness or pain. Scarring at your incision sites.
Do veins grow back after vein stripping? ›
In addition, there's mounting evidence that surgically removing veins increases the chance of them returning. After surgical procedures, the body's healing process kicks in, which can cause neogenesis, or regrowth of varicose veins. This is called postoperative neovascularization.
How painful is vein stripping? ›
These procedures can be done with minimal to no pain or discomfort, depending on the skill level of the performing vein specialist. The patient should only feel a few tiny pinches for numbing medication and some pressure, as if someone was pushing on your skin.
Is vein stripping major surgery? ›
Vein ligation and stripping is a minor surgery. It is used to remove a damaged vein and prevent complications of vein damage. If several valves in a vein and the vein itself are heavily damaged, the vein (or the diseased part of the vein) is removed (stripped).
Can you walk after varicose vein stripping? ›
Your doctor may recommend that you rest in bed or limit your activity for at least a few days after surgery. This can help reduce bruising. Resume activity as your doctor tells you. Take short walks several times a day.
Do they put you to sleep for vein stripping? ›
Vein stripping usually takes about 1 to 1 1/2 hours. You may receive either: General anesthesia, in which you will be asleep and unable to feel pain. Spinal anesthesia, which will make the lower half of your body feel numb.
Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay. This may be for at least several days. If you do strenuous activities too soon after the surgery, you may have some bleeding from your incisions.
What pain medication is given after vein stripping? ›
Post-surgery pain management is crucial for a comfortable recovery. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, are often effective for managing mild to moderate pain. For cases where pain is more pronounced, a varicose vein doctor or surgeon may prescribe stronger medication.
What happens if you don't wear compression stockings after vein ablation? ›
There was no significant difference in terms of bruising, recovery time, and leg swelling (Table I). He concluded that there is no evidence for the extended use of compression after endovenous ablation of varicose veins. In my daily practice, I routinely prescribe class 2 compression stockings after thermal ablation.
Is vein ligation the same as stripping? ›
The doctor will make small cuts in the area and then tie off (ligation) and remove the vein (stripping). You will probably go home the same day as the surgery. You will need to take it easy at home for at least a few days after the surgery.
What is the difference between vein stripping and ablation? ›
The primary difference in vein stripping vs ablation is that vein stripping is surgical varicose vein removal- an extraction of the vein from the body, whereas minimally invasive vein ablation is done endovenously while the vein remains in the body.
Can vein stripping cause blood clots? ›
While some clotting is to be expected, your body may respond harshly to the procedures. This response is known as superficial phlebitis (inflammation), which presents as redness, swelling, and pain in the treatment area. If left unaddressed, superficial phlebitis may sometimes (but rarely) lead to a DVT.
What is a vein ligation? ›
Venous ligation, as the name implies, essentially means tying off varicose veins through small incisions made in the skin in the affected areas. Vein stripping refers to the removal of larger varicose veins in a similar manner. Both procedures are usually done in outpatient surgery centers or in a hospital setting.
What has replaced vein stripping? ›
Endovenenous radiofrequency ablation or the Venefit Closure Procedure is one procedure that has replaced vein stripping surgery.
What is the difference between vein banding and vein clearing? ›
In vein clearing, veins become unnaturally clear or clear while, in vein banding, groups of lighter or more obscure shading show up along the primary veins of the plant leaves. Hence, this is the key distinction between vein clearing and vein banding.
What is a vein stripping? ›
Vein stripping is used to remove or tie off a large vein in the leg called the superficial saphenous vein. This helps treat varicose veins. Vein stripping usually takes about 1 to 1 1/2 hours. You may receive either: General anesthesia, in which you will be asleep and unable to feel pain.
