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Veins aren’t just a cosmetic issue; they can cause symptomatic distress too. Understand your vein health and the potential venous conditions you may be experiencing.
Understand what treatments are available for the venous condition you may be experiencing.
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Avulsions / Phlebectomies
Avulsions, also referred to as phlebectomies, are used as an alternative to foam sclerotherapy, for the treatment of any varicose veins that remain after endovenous laser ablation (EVLA) has treated the cause.
Unlike foam sclerotherapy – which just involves simple injections of a chemical to kill the varicosities, which in turn are absorbed slowly by the body – avulsions are used to physically remove the varicose veins.
Avulsions may be undertaken at the same time as the EVLA, but they do require a considerable volume of local anaesthetic. As such, if the maximum dose of anaesthetic has already been used for the EVLA treatment, it is often necessary to undertake the avulsions during a separate visit.
The first stage of the procedure is to mark the positions of the varicose veins on your skin while you are standing up. Once the skin of your leg is cleaned and drapes have been applied, the tissues over the marked varicose veins are injected with a dilute local anaesthetic to make the procedure painless.
Tiny incisions are then made, either with a needle or a fine scalpel blade at intervals of a few centimetres along the course of the varicose veins. A tiny crochet hook is inserted through the incisions, allowing the wall of the vein to be grabbed, and then the vein is teased out through the incision. Using small forceps, the vein is pulled and eventually detached. The operator then moves on to the next incision, and then the next, meaning that we can often remove long segments of vein at a time.
Once all of the varicose veins are removed, small adhesive dressings are applied to close the tiny wounds, a bandage is applied to reduce swelling and bleeding, and finally, a compression stocking is put on over this.
Although avulsions and foam sclerotherapy each have their own pros and cons, most of our patients are treated with foam sclerotherapy, because the latter is a simpler and quicker procedure to undertake, with less post-procedure discomfort in most cases.
The main advantage of avulsions is the speed of resolution of the varicose veins. It is particularly useful, therefore, if there is a forthcoming event like a wedding that you wish to be ready for in a short timeframe.
On the flip side, the disadvantages of avulsions include an increased risk of bleeding and infection and a greater chance of nerve damage.
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