Varicose Vein Stripping and Ligation

What is varicose vein stripping and ligation?

Varicose vein stripping and ligation is surgery to remove varicose veins in your legs. Your veins have valves inside them to help ensure that blood flows in the correct direction toward your heart. Varicose veins can occur if these valves become damaged or weakened and blood pools in your veins.

Vein ligation is “tying off” a varicose vein to stop blood from entering it. The vein is then stripped (removed from your body). After varicose vein stripping and ligation, your healthy veins take over to help restore normal blood flow.

Why would I need varicose vein stripping and ligation?

People choose to remove varicose veins for health or cosmetic reasons. Varicose veins affect up to 35% of U.S. adults and can cause:

• Feeling of heaviness in your legs.
• Itching.
• Pain, soreness and muscle cramps.
• Skin discoloration and sores.
• Swelling.
• Twisting, ropelike bulges in your legs that may be blue or purple.

Providers also perform vein stripping and ligation to treat chronic venous insufficiency (CVI). CVI is another condition that can occur when valves in your leg veins become damaged. You might experience symptoms like pain, swelling and skin sores with CVI due to blood pooling in your legs. CVI usually occurs because of a blood clot in your legs known as deep vein thrombosis (DVT).

Who performs varicose vein stripping and ligation?

A vascular surgeon performs this procedure. This type of surgeon specializes in treating conditions that affect your blood vessels and circulation.

What happens before varicose vein stripping and ligation?

Your healthcare provider will give you specific instructions to prepare for the procedure. For instance, you may need to stop eating or drinking several hours before your surgery. You may also need to stop taking certain medications.

What happens during varicose vein stripping and ligation?

Providers perform vein stripping and ligation at an outpatient surgery center or in their office. However, you will need someone to drive you home after your surgery.

When it’s time for your procedure, your provider gives you anesthesia to keep you from feeling pain. For vein stripping and ligation, you may receive:

• A sedative (medicine to make you sleepy) with regional anesthesia (blocks pain in the area of the procedure).
• General anesthesia, which makes you unconscious.

Once your anesthesia is working, your provider makes small incisions in your groin and lower leg. They locate varicose veins using ultrasound imaging. Then, your provider ties off the veins and removes them.

In some cases, your provider may use endovenous thermal ablation. This newer technique uses heat or laser energy to close off varicose veins. Varicose vein stripping and ligation usually takes one to three hours.

What happens after varicose vein stripping and ligation?

After your procedure, you go to a recovery area while your anesthesia or sedation wears off. Then, you go home with your provider’s instructions for your recovery. During your recovery, you may need to:

• Care for your incisions by keeping them clean and dry.
• Elevate your affected leg whenever possible.
• Wear compression stockings. Ask your provider which stockings they recommend for you.

What are the advantages of varicose vein stripping and ligation?

Varicose vein stripping and ligation is an effective way to treat varicose veins and some cases of CVI. This surgery generally works well even on severe cases, or very large varicose veins.

Because your provider removes the affected vein during the surgery, there’s no risk of the varicose vein coming back. Vein stripping and ligation is also an outpatient surgery, so you can go home the same day.

What are the risks or complications of varicose vein stripping and ligation?

When you choose an experienced and skilled provider, there’s a low risk of complications. However, possible side effects include:

• Allergic reaction to anesthesia.
• Blood clot in your leg.
• Infection at the site of your incisions.
• Irritation of a nerve near the removed vein, which can cause numbness or pain.
• Scarring at your incision sites.

What is the recovery time?

Full recovery from vein stripping and ligation takes two to four weeks and you:

• Can resume your normal diet right away.
• May need to avoid vigorous exercise until you have fully recovered.
• Should walk and move around frequently to help prevent blood clots.

When should I see my healthcare provider?

Seek medical care if you experience:

• Bleeding at your incision sites.
• Fever.
• Pain that gets worse instead of better.
• Skin that feels warm to the touch.
• Swelling in your leg.

A note from Cleveland Clinic

Vein ligation and stripping is an effective way to treat and remove varicose veins. This surgery can relieve pain, swelling and other symptoms. Vein stripping and ligation can also improve the appearance of your legs. If you have varicose veins that are interfering with your life, talk to your provider. Together, you can discuss treatment options and what will work best for your health needs and lifestyle.