Definition

Vein stripping is surgery to remove varicose veins in the legs.

Alternative Names

Vein stripping with ligation; Vein stripping with avulsion; Vein stripping with ablation; Vein ligation and stripping; Vein surgery; Venous insufficiency - vein stripping; Venous reflux - vein stripping; Venous ulcer - veins

Description

Varicose veins are swollen, twisted, and enlarged veins that you can see under the skin. They are often red or blue in color. They usually appear in the legs but can occur in other parts of the body.

Normally, valves in your veins keep your blood flowing up toward the heart, so the blood does not collect in one place. The valves in varicose veins are either damaged or missing. This causes the veins to become filled with blood, particularly when you are standing.

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.
• Spinal anesthesia, which will make the lower half of your body feel numb. You may also get medicine to help you relax.

During surgery:

• Your surgeon will make 2 or 3 small cuts in your leg.
• The cuts are near the top, middle, and bottom of your damaged vein. One is in your groin. The other will be farther down your leg, either in your calf or ankle.
• Your surgeon will then thread a thin, flexible plastic wire into the vein through your groin and guide the wire through the vein toward the other cut farther down your leg.
• The wire is then tied to the vein and pulled out through the lower cut, which pulls the vein out with it.
• If you have other damaged veins near the surface of your skin, your surgeon may also make small cuts over them to remove them or tie them off. This is called ambulatory phlebectomy.
• Your surgeon will close the cuts with stitches.
• You will wear bandages and compression stockings on your leg after the procedure.

Why the Procedure Is Performed

Your health care provider may recommend vein stripping for:

• Varicose veins that cause problems with blood flow
• Leg pain and heaviness
• Skin changes or sores that are caused by too much pressure in the veins
• Blood clots or swelling in the veins
• Improving the appearance of your leg
• Varicose veins that can't be treated with newer procedures

Today, surgeons are rarely performing vein stripping surgeries because there are newer, non-surgical ways to treat varicose veins that don't require general anesthesia and are done without an overnight hospital stay. These treatments are less painful, have better results, and have a much faster recovery time.

Risks

Vein stripping is generally safe. Ask your surgeon about any problems that might occur.

Risks of anesthesia and surgery in general are:

• Reactions to medicines
• Breathing problems
• Bleeding, blood clots
• Infection

The risks from vein stripping include:

• Bruising or scarring
• Nerve injury
• Return of varicose veins over time

Before the Procedure

Always tell your surgeon:

• If you are or could be pregnant
• What medicines you are taking, including medicines, supplements, or herbs you bought without a prescription
• If you have been drinking more than 1 or 2 alcoholic drinks a day

During the days before your surgery:

• You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), blood thinners such as warfarin (Coumadin), and other drugs.
• Ask your surgeon which medicines you should still take on the day of your surgery.

On the day of your surgery:

• You will likely be asked not to drink or eat anything for at least 6 to 8 hours before surgery.
• Take your prescribed medicines with a small sip of water.

After the Procedure

Your legs will be wrapped with bandages to control swelling and bleeding for 3 to 5 days after surgery. You may need to keep them wrapped for several weeks.

Outlook (Prognosis)

Surgical vein stripping reduces pain and improves the appearance of your leg. Rarely, vein stripping causes scars. Mild leg swelling can occur. Be sure you regularly wear compression stockings.

References

Iafrati MD. Varicose veins: surgical treatment. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 154.

Pascarella L, Marston W. Venous disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 65.

Weitz JI, Ekelboom JW. Venous thrombosis and embolism. In: Goldman MP, Cooney KA, eds. Sclerotherapy. 7th ed. Philadelphia, PA: Elsevier; 2024:chap 68.