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Vein Ligation and Stripping

Surgery Overview

Vein ligation and stripping is a minor surgery. It is used to remove one or more varicose veins. These are twisted, swollen veins near the surface of the skin. They are most common in the legs and ankles. The surgery can also be done to prevent venous skin ulcers from coming back after treatment.

You will probably be asleep during the surgery, but it also can be done while you are awake. If you are awake, you will get medicine to numb your leg and prevent pain. The doctor make small cuts in the area and then ties off (ligation) and removes the vein (stripping).

You will probably go home the same day as the surgery. You will need to take it easy at home for 3 to 7 days after the surgery. How long it takes for you to recover depends on how many veins are removed.

After surgery, problems caused by the varicose veins should go away. Other veins in the legs will take over the work of the veins that are removed.

What To Expect

Vein ligation and stripping typically don't require a hospital stay. They are most often 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 get back to your normal activities.

Why It Is Done

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:

  • You want to get rid of varicose veins for cosmetic reasons and you don't have other health problems that would make surgery more risky.
  • Your legs ache, swell, or feel heavy, especially after prolonged standing.
  • A varicose vein bleeds.
  • Open sores (ulcers) develop because of varicose veins or poor blood circulation in a vein.
  • The vein is damaged in the section where it joins the superficial and deep veins in the knee or groin.

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.

Who should not have ligation or stripping

Vein ligation and stripping should not be done in:

  • Older adults for whom surgery poses a high risk due to other medical conditions.
  • People who have poor circulation in the arteries of the legs.
  • People who have swelling and fluid buildup due to blockage in the lymph vessels (lymphedema), skin infections, or blood-clotting defects.
  • Women who are pregnant.
  • People who have an abnormal passageway between an artery and vein (arteriovenous fistula) in the leg.

Learn more

How Well It Works

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

Risks

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.

References

Citations

  1. Van den Bos R, et al. (2009). Endovenous therapies of lower extremity varicosities: A meta-analysis. Journal of Vascular Surgery, 49(1): 230–239.

Credits

Current as of: July 6, 2021

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
David A. Szalay MD - Vascular Surgery

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