Micro-incision vein removal has largely been supplanted by foam sclerotherapy which is a less invasive, safer, far more comfortable procedure with excellent long term results.
During an ambulatory phlebectomy, the diseased vein segments are first identified and marked with the help of Duplex ultrasound. The vein is then extracted through tiny incisions or even needle punctures using delicate instruments designed for this purpose. It is important to keep in mind that the ropy varicose veins visible on the surface are almost always part of a "system" of veins, which have at their source either in an incompetent saphenous trunk or a perforator vein.
The treatment therefore, should always address the veins at their source and ambulatory phlebectomy is usually performed in conjunction with sclerotherapy, endovenous laser treatment (The Vein and Laser Clinic does not perform EVLT) or ligation.