Ambulatory phlebectomy.

Abstract

BACKGROUND: Ambulatory phlebectomy (AP) is a gratifying technique that allows one to solve problems otherwise requiring traditional surgery. However, when AP is practiced indiscriminately, results may be disappointing and can tarnish the technique, although there is always a solution to restore the situation. OBJECTIVE: To evaluate the defects of AP, their frequency, and to propose solutions for treatment and prevention. METHODS: This study was based on a review of 900 patients who underwent AP with no less than 6 months follow-up. Complications were grouped into three categories: cosmetic, functional, and efficacious (recurrence rates). RESULTS: Cosmetic problems included pigmentation, tattooing, telengiectatic matting, and appearance of new varicose veins. Functional problems included paresthesia and edema. Hematomas disappeared within 3 weeks but sometimes led to pigmentation. CONCLUSIONS: After having analyzed all the reasons for complications, we can formulate logical solutions. Risks may be greatly reduced by strict adherence to proper technique, patient selection, and pretreatment venous mapping. For all complications we found a solution. Sclerotherapy is used in all cases because AP, like all surgical techniques, leads to recurrence when performed alone. In this study, all the described side effects were treated by sclerotherapy, which remains the only solution that gives good results in all cases.