This procedure is used for treating varicose veins too large to treat with sclerotherapy (injection of a special solution) or topical laser therapy.  Multiple very small incisions are made in the skin under local anesthetic and the vein is removed with a special instrument.  Other than mild stinging from the local anesthetic, this procedure is painless.  For very long veins or multiple veins we sometimes will do this procedure in two settings.

Before the Procedure:

• You will need someone to drive you to and from the procedure.
• If you feel like you need sedation during the procedure, contact our Nurse at (919) 854-2180 and request a prescription for this.  Please take this medication one hour before your scheduled procedure in order for it to take effect.
• Bring your prescription compression stocking(s) with you.  It is important that the stocking be applied after the procedure to apply compression to the leg.
• You should be well hydrated before the procedure, so drink plenty of fluids.  Do not eat for a few hours before the procedure.

After the Procedure

• It is not unusual for there to be some bleeding through the dressing while you are upright immediately after the procedure.  If this occurs, simply lie down, elevate the leg above the level of your heart and have someone apply gentle pressure for about five minutes to the bleeding site with a dry washcloth.  Wait 30 minutes or so before getting up again.  If the bleeding starts again, repeat.  This does not indicate a serious problem.  Feel free to call us if you have concerns.
• Most patients are able to return to work the following day.  If you are on your feet for most of the day, or very active, you might need to take a day or two off before returning to work.  Some patients do better working half days for the first week or so.
• Leave the compression stockings and ace-wrap dressing on for the first 48 hours.  Some patients find the stocking painfully compresses the foot.  If this is the case, you may cut away this part of the stocking with scissors.(just cut the front part of the foot part of the stocking, leaving the heel part intact.   Otherwise the stocking will slide up the leg)
• After 48 yours you can remove the stocking and ace-wrap.  Carefully remove the gauze pads so that you do not pull the small adhesive strips from the skin. You may gently clean the skin with soap and water, taking care not to rub off the adhesive strips.  After a week it is OK to bathe and shower normally.  The adhesive strips can be removed at this time if they have not already fallen off.
• Continue to wear the stocking during the day for a total of two weeks.
• Some segments of vein will not be removed.  There will be local inflammation in these segments which may be uncomfortable.  You may take Ibuprophen 800mg (four over the counter tablets) three times per day.  This will reduce the inflammation as well as treating the discomfort.
• Call us if there are any problems or questions.   Any questions that cannot be answered by our nurse will be referred to the physician.You will need to see us back in the clinic two weeks after the procedure.  If you need an additional procedure we may perform it at this time.