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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.
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.
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:
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.
Vein ligation and stripping should not be done in:
Vein ligation and stripping removes varicose veins successfully in 80 out of 100 people. That means it does not work for 20 out of 100 people.footnote 1
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.
If you are thinking of ligation and stripping, consider some questions to ask about varicose vein treatment. For example, you may want to ask how much the exam and treatment cost.
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.
Van den Bos R, et al. (2009). Endovenous therapies of lower extremity varicosities: A meta-analysis. Journal of Vascular Surgery, 49(1): 230–239.
Current as of:
March 4, 2020
Author: Healthwise StaffMedical Review: E. Gregory Thompson MD - Internal MedicineAdam Husney MD - Family MedicineDavid A. Szalay MD - Vascular Surgery
Current as of: March 4, 2020
E. Gregory Thompson MD - Internal Medicine & Adam Husney MD - Family Medicine & David A. Szalay MD - Vascular Surgery
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