What is ligation and stripping for venous disease?
Ligation means the surgical tying of veins through a small incision in the skin to prevent pooling of blood. Ligation may be used in conjunction with vein stripping, or removal of the vein. In many instances, the vein is removed using a minimally invasive surgical procedure called venous ablation.
Why is this procedure performed? Why do I need this procedure?
Surgery is done for two main reasons. The first is to treat varicose veins. In conjunction with removal of the varicose veins, ligation and stripping of veins is often performed to help prevent recurrence of the varicose veins. This is typically done if there is evidence of valvular incompetence within the main veins that give rise to the varicose veins.
Ligation and stripping is also done when pooling of blood occurs secondary to venous incompetence, and patients suffer from symptoms of venous insufficiency. These symptoms include leg swelling, skin changes, pain and, in severe cases, ulceration. The removal of the malfunctioning vein helps to control symptoms, and in cases of ulceration it helps the ulcers to heal. Surgical removal or stripping of the vein is rarely needed but may be recommended in some situations to treat superficial venous thrombosis or phlebitis.
Each patient is evaluated, and treatment will be individualized for the patient’s circumstances.
Where is the procedure performed and who performs this procedure?
Surgical treatments are performed in the hospital or outpatient setting by a vascular surgeon.
What are the risks and potential complications of the procedure?
Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you. This is generally a very safe procedure, causing relatively little pain and, in most cases, is well-tolerated. However, as with any surgical procedure, there are risks, including infection at the site of the incisions, the development of a clot in the vein in the leg, and irritation of a nerve that runs along with the veins that are typically stripped.
Special precautions are taken to decrease these risks, and there may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand the risks of the procedure and why the procedure is recommended.
How do I prepare for the ligation and/or stripping?
A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to perform the procedure. You may need to discontinue certain medications before the procedure. Your healthcare team will provide specific instructions to help you prepare for the procedure.
What happens during the procedure?
You will receive a sedative and a regional anesthesia, or you may receive general anesthesia. Your surgeon will make small incisions in the groin and in the calf below the knee. The dilated vein is then either removed, , tied off, or will undergo ablation through those small incisions.
How long does the procedure last?
The procedure itself generally takes two to three hours. This is typically performed in the outpatient setting, and you can anticipate returning home a few hours after the surgery. Full recovery will take one to two weeks. .
What happens after the procedure?
Your surgeon will give you specific instructions you need to follow after the surgery until your incision heals adequately. Typically these will involve limiting your activity, elevating your leg whenever possible, and wearing compression hose.
Are there any side effects of the treatment?
As with any surgical procedure, you will feel somewhat tired for a few weeks. In addition, you will have pain at the sites of the incision, you may experience pain along the sites of ablation, and you may get bruising at the sites of ligation and stripping. The discoloration from bruising typically resolves over a few weeks, but in rare cases it can persist. Very rarely, if the nerve that runs along with the vein is irritated, patients may experience numbness and tingling along the front of the lower leg.
What are typical results of the procedure?
Your doctor will discuss the results of the procedure with you, but outcomes are generally good.
How do I find out if I am a candidate for this procedure?
Vascular Surgery Department at 216.444.4508 or 800.223.2273 ext. 4-4508.