Surgery 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). An incision is made below the
vein, a flexible instrument is threaded up the vein to the first incision, and
the vein is grasped and removed.
During this surgery, one or more incisions are made over the
damaged veins, and the vein is tied off (ligated). If the ligation cuts off a
faulty valve and the vein and valves below the faulty valve are healthy, the
vein may be left in place to continue circulating blood through other veins
that still have valves that work well.
What To Expect After Surgery
Vein ligation and stripping typically do not require a hospital
stay and are done on an outpatient basis with
regional or general anesthesia. Most people go home
the same day of their surgery.
Most likely, you will be able to return to work within a few days.
After several weeks, you can resume normal leisure and recreational
activities.
Why It Is Done
Vein ligation and stripping is generally done on large
varicose veins. It also can be done to prevent
venous skin ulcers from returning after treatment.
This surgery may be used when:
- You want to get rid of varicose veins for
cosmetic reasons and you don't have other health problems that would make surgery
more risky.
- Your legs ache, swell, or feel heavy, especially after
prolonged standing.
- A varicose vein bleeds.
- Open sores
(ulcers) develop because of varicose veins or poor blood circulation in a
vein.
- The vein is damaged in the section where it joins the
superficial and deep veins in the knee or groin.
If you have both small and large varicose veins, you may have more
than one type of treatment. Following vein ligation and stripping to treat
large varicose veins, you may have
sclerotherapy to treat smaller varicose veins.
Who should not have ligation or stripping
Vein ligation and stripping should not be done in:
- Older adults for whom surgery poses a high
risk due to other medical conditions.
- People who have poor
circulation in the arteries of the
legs.
- People who have swelling and fluid buildup due to blockage in
the lymph vessels (lymphedema), skin infections, or blood-clotting
defects.
- Women who are pregnant.
- People who have an
abnormal passageway between an artery and vein (arteriovenous fistula) in the
leg.
How Well It Works
Vein ligation and stripping removes varicose veins and keeps them from coming back in 90
out of 100 people. It doesn't work for 10 out of 100 people.1
Risks
Vein ligation and stripping surgery has some risks, such as
scarring and varicose veins recurring. Also, if the deep vein system is
damaged, surgery may make problems with blood flow in the veins worse. Varicose
vein surgery has the same risks associated with general surgery, including
infection, bleeding, and
anesthesia risks.
If the largest vein in the leg (great saphenous vein, or GSV) is
stripped below the knee, numbness may result due to nerve injury.
What To Think About
For help deciding whether to have a procedure for varicose veins, see:
Varicose Veins: Should I Have a Surgical Procedure?
In the past there was concern about removing the great saphenous
vein, because this vein is often used as a replacement or graft for an artery
in the heart when a person has bypass surgery. Doctors now believe that there
is no reason not to strip the GSV in the leg if needed. If the vein is badly
damaged, it will not work as a vein graft anyway. In most cases a blood vessel
from the chest (mammary artery) can be used during heart bypass surgery instead
of the GSV. If necessary, arm veins can be used.
Vein stripping surgery is seldom done for people who have
chronic venous insufficiency (CVI) resulting from deep
vein problems and who also have varicose veins. Removing varicose veins close
to the surface of the skin (superficial varicose veins) may cause problems if
the deep leg veins are also damaged. If you are considering this surgery, get
an opinion from a vascular specialist.
If you are thinking of ligation and stripping,
consider some
questions to ask about varicose vein treatment. These
questions include: How much experience does the doctor have with the particular
treatment? How much do the exam and treatment cost?
Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Wakefield TW, et al. (2010). Varicose veins section of Veins and lymphatics. In GM Doherty, ed., Current Surgical Diagnosis and Treatment, 13th ed., pp. 790–792. New York: McGraw-Hill Medical.
Credits
| By | Healthwise Staff |
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| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
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| Specialist Medical Reviewer | David A. Szalay, MD - Vascular Surgery |
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| Last Revised | February 1, 2012 |
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Wakefield TW, et al. (2010). Varicose veins section of Veins and lymphatics. In GM Doherty, ed., Current Surgical Diagnosis and Treatment, 13th ed., pp. 790–792. New York: McGraw-Hill Medical.
