The traditional treatment for varicose veins was to surgical strip or ligation of the great saphenous vein. The great saphenous vein (GSV) used to be called the greater saphenous vein adn is the long vein that extends from the anklebone to the groin, along the inside of the leg and thigh. The great saphenous vein empties into the common femoral vein in the groin. Ligation and stripping involves tying off the abnormal vein (ligation) and physically pulling and ripping the vein branches while removing it (stripping).
Ligation can be performed in an office setting, however stripping is routinely performed in a hospital setting or outpatient surgical center under local, spinal, or general anesthesia. The surgeon performed the ligation or stripping by making a small incision in the groin to gain access and expose the diseased great saphenous vein, which is then tied off. The surgeon then makes a series of small incisions along the leg from the thigh to a point just below the knee or to the ankle. Using a specialized tool (stripping tool), that is inserted and then threaded through the subsequent incisions, the surgeon strips out the diseased vein.
A more recent tequnique for vein stripping is called PIN (Perforate Invaginate) stripping. This technique involves inserting an instrument called a PIN stripper through a small incision in the lower leg. The surgeon then uses the stripper to advance through the vein, its tip is sewn to the end of the vein, and the vein is pulled in on itself as it is removed or stripped out of the leg. PIN stripping can also be performed in a hospital operating room or outpatient surgical center under general anesthesia or local anesthesia with IV sedation.
During vein stripping, many branch veins attached to the GSV are broken, causing blood to leak into surrounding tissues. This causes the postoperative pain, soreness and bruising experienced by ligation and stripping patients. Other potential complications include numbness from damage to surrounding nerves, chronic leg swelling from damaged lymphatic tissue, incision scars and allergic reaction to anesthesia. Although the patient is usually able to return home the same day, recovery from vein stripping surgery can take two to four weeks.During that time patients are often sidelined for several days.
Advnacements in the treatment of vein disease have all but eliminated vein stripping in the United States. Surgical vein stripping is far more invasive than the VenaCure EVLT™ or VenaFit Radiofrequency ablation procedures. Additionally, a study published in the Journal of Vascular Surgery (JVU) in 1999 revealed that vein stripping surgery was only 71% effective in eliminating varicose veins, compared to a success rate of 98% for the ClosureFast or VenaCure EVLT™ procedures. Endovenous laser vein therapy has additional benefits including: less bruising and numbness and leaves minimal to no scarring of the extremity when compared to surgical ligation and vein stripping