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.
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.
Surgical treatments are performed in the hospital or outpatient setting by a vascular surgeon.
To find out if you are a candidate for this procedure, please call the Vascular Surgery Department at 216.444.4508 or 800.223.2273 ext. 4-4508.
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.
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.
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.
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.
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.
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.
Your doctor will discuss the results of the procedure with you, but outcomes are generally good.
Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.
Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart and Vascular Institute Outcomes.
Choosing a doctor to treat your vascular disease depends on where you are in your diagnosis and treatment. The following Heart and Vascular Institute Sections and Departments treat patients with all types of vascular disease, including blood clotting disorders:
Section of Vascular Medicine: for evaluation, medical management or interventional procedures to treat vascular disease. In addition, the Non-Invasive Laboratory includes state-of-the art computerized imaging equipment to assist in diagnosing vascular disease, without added discomfort to the patient. Call Vascular Medicine Appointments, toll-free 800-223-2273, extension 44420 or request an appointment online.
Department of Vascular Surgery: surgery evaluation for surgical treatment of vascular disease, including aorta, peripheral artery, and venous disease. Call Vascular Surgery Appointments, toll-free 800-223-2273, extension 44508 or request an appointment online.
IVC Filter Retrieval Clinic - to make an appointment, call Vascular Medicine at 216.444.4420. Ask for Dr. Bartholomew in the Filter Retrieval Clinic. Your appointment will include a consultation with Dr. Bartholomew and the physicians who will perform the IVC filter retrieval procedure.
You may also use our MyConsult second opinion consultation using the Internet.
The Heart and Vascular Institute also has specialized centers and clinics to treat certain populations of patients:
Learn more about experts who specialize in the diagnosis and treatment of vascular and arterial disease.
If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 08/14/2019