What to Expect Before, During, and After Vascular Surgery for Varicose Veins

Varicose veins are enlarged, bulging, and twisted blue veins that become visible beneath the skin of the legs. They form when the valves in the veins weaken or stop working properly, causing increased pressure as the veins work against gravity to return blood to the heart. Genetics can also greatly increase the likelihood of developing varicose veins. They can cause leg aches, fatigue and skin changes like rashes, redness, leg swelling, blood clots, or sores. Getting treatment can boost your overall comfort and improve both leg function and blood circulation.

Vascular Surgery for Varicose Veins

Vascular surgery for varicose veins involves removing or sealing off damaged veins that bulge and twist. Common methods include vein stripping (ligation and stripping), which involves removing a portion of the vein, and ambulatory phlebectomy, where the vein is pulled out through tiny skin incisions. A vascular surgeon decides the most suitable treatment method depending on the size, severity, and location of the varicose veins.

Varicose vein stripping and ligation is a surgical procedure aimed at removing varicose veins from the legs. Veins contain valves that help direct blood flow toward the heart. If these valves become damaged or weakened, varicose veins occur, and blood pools in your veins.

Vein ligation means “tying off” a varicose vein to stop blood from entering it. The vein is then removed from the body. After the procedure, healthy veins take over to restore normal blood flow. This surgery is performed by a vascular surgeon who specialises in treating blood vessel and circulatory conditions.

Before Surgery

Before vascular surgery, you’ll have a consultation and medical evaluation, potentially including imaging and a review of your medications and history.  Discuss medications, allergies, and existing conditions. Your doctor may order a Doppler ultrasound to map vein function. Before varicose vein surgery, arrange for transportation and follow your doctor’s instructions to stop taking blood thinners and certain anti-inflammatory medications (such as aspirin or ibuprofen). Additionally, stop smoking, maintain a healthy weight, and adhere to any pre-surgery guidelines, including fasting if anaesthesia will be used.

On the day of the procedure, you should avoid moisturising your legs, wear loose clothing, and ensure you have compression stockings to wear afterwards. Be sure to inform your care team about any medications, allergies, and removable dental work you might have. 

Surgery Process

You will be given specific instructions to prepare for the procedure. When it’s time for your procedure, your healthcare provider will give you anaesthesia to keep you from feeling pain. For vein stripping and ligation, anaesthesia may be administered either regionally or generally. The surgeon will make small incisions in your groin and lower leg. Using ultrasound imaging, the surgeon identifies the varicose veins, then ties them off and removes them.

In certain cases, your doctor may perform endovenous thermal ablation, a modern technique that uses heat or laser energy to seal varicose veins. The traditional stripping and ligation procedure typically lasts one to three hours.

After your procedure, you go to a recovery area till your anaesthesia or sedation wears off. Then, you will return home following your provider’s recovery instructions. Arrangements should be made for someone to drive you home. At home, you must care for your incisions by keeping them clean and dry. You will be asked to elevate your affected leg whenever possible. Your doctor may recommend wearing compression stockings.

Recovery and Outlook

Recovery from vein stripping and ligation generally takes two to four weeks, and you may return to your normal diet immediately. The doctor may advise you to avoid vigorous exercise until you have fully recovered. Your doctor will recommend regular walking and movement to reduce the risk of blood clots.

Risks and Benefits of Varicose Vein Stripping and Ligation

Varicose vein stripping and ligation can provide effective long-term relief for severe varicose veins and their symptoms like pain, swelling, and cosmetic concerns, but it is an invasive surgical procedure with risks including infection, nerve irritation, deep vein thrombosis (DVT), bruising, and scarring. While it offers a high success rate in eliminating large, symptomatic veins, it typically involves longer recovery times and more pain than modern minimally invasive treatments like radiofrequency ablation (RFA) or endovenous laser ablation (EVLA), which are now often preferred for their reduced invasiveness and quicker recovery periods. 

Benefits

• Effective Symptom Relief: It provides immediate and long-term relief from pain, aching, heaviness, and swelling associated with varicose veins. 
• Cosmetic Improvement: It removes unsightly bulging veins, improving the appearance of the legs and potentially boosting self-confidence. 
• Prevention of Complications: By addressing the underlying venous issues, the surgery can help prevent more serious complications like venous ulcers, skin discoloration, and bleeding. 
• Works for Severe Cases: This procedure is effective in treating large and severe varicose veins that may not be suitable for less invasive methods. 
• Long-Term Results: The treatment offers lasting relief by eliminating the affected veins, reducing the risk of recurrence in the treated area. 

Risks

• Infection: Incisions made during the surgery can become infected. 
• Bruising and Scarring: The procedure can lead to bruising and scarring at the incision sites. 
• Nerve Irritation or Damage: Nerves near the removed vein can be irritated or damaged, causing temporary or permanent numbness, tingling, or pain. 
• Blood Clots: One possible complication is deep vein thrombosis (DVT), which occurs when a clot develops in a vein located deep within the body.
• Bleeding: Bleeding can occur at the incision sites during or after the procedure. 
• Recurrence: New varicose veins can develop after surgery, as seen in about 30% of patients within two years in some studies. 
• Pain and Discomfort: Patients might experience considerable pain and discomfort while recovering. 
• Extended Recovery: Compared to minimally invasive options, stripping and ligation typically involve longer recovery times

Summary

Treating varicose veins can significantly improve their appearance, comfort, and quality of life. Today’s advanced procedures make relief quicker and more convenient than ever. You should consult with a vein specialist to determine the best treatment plan for your specific condition. 

Frequently Asked Questions