Miniphlebectomy – a modern method for varicose vein removal

Miniphlebectomy is a technique for removing segments of varicose veins under local anesthesia through small skin punctures. It does not require general anesthesia and is performed on an outpatient basis.

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What is varicose veins and why do they occur?

Reduced physical activity, hormonal changes, and excess weight decrease the effectiveness of leg muscles. Varicose veins develop almost unnoticed. According to statistics, in developed countries, varicose vein disease affects approximately 35% of women and 10–20% of men.

You should consult a phlebologist if you notice:

heaviness and swelling in the lower limbs;
night cramps, skin redness;
the appearance of telangiectasias (spider veins, vascular networks);
enlarged, bulging veins in the lower limbs.

How varicose veins are classified: the CEAP system

C – clinical manifestations identified during physical examination;
E – etiology of the disease:

“c” – congenital pathology
“p” – primary lesion
“s” – secondary lesion

P – pathophysiological component of the disease, where:

“r” – reflux
“o” – obstruction
“r, o” – reflux and obstruction

A – anatomical changes (based on duplex ultrasound examination), where:

As – superficial vein involvement
Ad – deep vein involvement
Ap – perforator vein involvement

Stages of varicose vein disease

С0

no visible signs of venous pathology (C0s – presence of symptoms typical of venous insufficiency, such as: complaints of swelling, heaviness, discomfort; possible night cramps, pain, and other manifestations of the disease)

С1

telangiectasias or reticular veins are visible during examination. At this stage, laser vein closure is the first step in eliminating the vascular network; additionally, CLaCS treatment is performed.

С2

visible varicose veins are present; EVLA or RFA is performed, along with another minimally invasive technique combined with miniphlebectomy, which helps prevent the progression of varicose disease to more severe forms.

С3

at this stage, in addition to varicose veins, leg swelling is also present; after EVLA or RFA and another minimally invasive technique combined with miniphlebectomy, leg swelling typically subsides as early as the next day.

С4

this is a severe form of varicose vein disease in the lower limbs, characterized by significant trophic changes without a trophic ulcer; EVLA or RFA is performed, along with another minimally invasive technique combined with miniphlebectomy to prevent complications.

С5

skin changes with a healed trophic ulcer; the ulcer healed thanks to EVLA or RFA and another minimally invasive technique combined with miniphlebectomy.

С6

skin changes with an active trophic ulcer; EVLA or RFA is performed, along with another minimally invasive technique combined with miniphlebectomy, which are allowed even in the presence of open trophic ulcers.

Development of Varicose Veins

Varicose vein disease can be caused by factors such as heredity, age, hormonal changes, pregnancy, excess weight, and a sedentary lifestyle. Signs that indicate the need to consult a phlebologist include visible veins, pain, swelling, cramps, skin darkening, or leg ulcers. Duplex ultrasound scanning helps determine the nature of the venous system damage and the need for correction of pathological blood flow in the superficial venous system.

How to Recognize the First Signs of Varicose Veins

Very often, even in the presence of varicose nodes, there may be no complaints of pain, swelling, or trophic skin changes. However, complications and significant symptoms can arise quickly and unexpectedly. That’s why it is recommended to eliminate varicose veins in the lower limbs with EVLA surgery at the early stages. Laser vein removal in the lower limbs helps prevent complications such as thrombosis and the formation of open trophic ulcers.

What Happens If Varicose Veins Are Not Treated

Varicose vein disease does not remain static. Over time, vascular tone weakens and the efficiency of venous valves decreases. It is important to consult a phlebologist or vascular surgeon in a timely manner to properly diagnose the condition. Delaying treatment of varicose veins leads to complications such as the development of trophic ulcers, venous insufficiency, skin darkening, or leg ulcers. The earlier you consult a phlebologist, the more effective the treatment will be—without complications.

When is miniphlebectomy indicated?

Miniphlebectomy is most often performed in combination with obliteration of varicose veins in the lower limbs. With the exception of telangiectasias and the proximal part of the great and small saphenous veins, most other superficial veins of the lower limbs are accessible for removal using the miniphlebectomy method. The advancement of this minimally invasive technique makes it possible to treat varicose veins even in elderly patients.

Miniphlebectomy is characterized by:

the technique combines effectiveness with aesthetic results

removal of varicose vein segments is performed under local anesthesia.

performed either alone or in combination with vein obliteration

carried out on an outpatient basis

minimal postoperative discomfort that does not limit the ability to walk

achieves long-lasting aesthetic results

Advantages of Miniphlebectomy

Miniphlebectomy allows for thorough and high-quality removal of varicose veins in various locations.

Advantages of the technique:

performed under local anesthesia
outpatient procedure that does not require hospitalization
tiny puncture scars disappear within 3–6 months
quick return to normal activity
guaranteed aesthetic result

Why Miniphlebectomy Is a Modern Solution

Patients with asymptomatic venous disease may seek treatment to remove varicose veins in the lower limbs for cosmetic reasons, due to a family history of varicose disease, or to prevent potential complications of venous pathology. Based on the initial examination, patients are selected for miniphlebectomy either as a standalone procedure or in combination with other minimally invasive techniques aimed at eliminating vascular reflux: EVLA, RFA, or ultrasound-guided sclerotherapy.

Advantages of the technique:

performed on an outpatient basis, without hospitalization;
minimally invasive;
effective – visible veins disappear as early as the next day;
maximum cosmetic effect observed within six months.

Miniphlebectomy can be the definitive solution for the removal of varicose veins.

How the Miniphlebectomy Procedure Is Performed

The initial consultation regarding existing varicose veins in the lower limbs allows the phlebologist or vascular surgeon to identify, after examination, patients with venous reflux and determine which specific vessels need to be treated. Thus, preparation for surgery and the procedure itself includes:

Consultation and ultrasound diagnostics

Consultation with a phlebologist or vascular surgeon, including diagnostics using duplex ultrasound scanning (DUS)

Консультация и УЗД диагностика у флеболога

Selection of the treatment method and assignment of additional examinations

Medical history collection and diagnosis, identifying varicose tributaries, reticular varicose veins, and feeder veins supplying telangiectasias

Performing miniphlebectomy

If duplex ultrasound shows that the great or small saphenous veins are incompetent, the insufficiency of the saphenous veins is treated first – EVLA, RFA, or ultrasound-guided sclerotherapy is performed. After that, miniphlebectomy is carried out – removal of varicose vein segments through a small puncture under local anesthesia.

Follow-up examination

The necessary follow-up examination is performed the next day, the dressing is removed, and ultrasound monitoring of the closed veins is conducted.

Rehabilitation

Within a month after miniphlebectomy, wearing medical compression stockings is recommended to ensure proper graduated compression.

Follow-up examination with ultrasound monitoring

The necessary examination with ultrasound monitoring is carried out the next day and repeated after 30 days.

When Miniphlebectomy Is Not Performed

Before performing miniphlebectomy, the surgeon must ensure the patency of the deep veins and confirm the absence of contraindications.

Contraindications for Miniphlebectomy

severe venous or lymphatic edema
presence of infection or dermatitis in the intervention area
serious general somatic diseases
presence of cellulitis in the intervention area
mobility disorders
pregnancy
drug allergies

Why choose Phlebos Clinic

Specialized medical care

Experience of practicing vascular surgeons ranges from 10 to 28 years

Modern equipment in examination rooms and operating theaters

Outpatient treatment under local anesthesia

How much does miniphlebectomy cost in Kyiv?

Miniphlebectomy is usually performed in combination with a thermal method of varicose vein removal: endovenous laser coagulation (EVLA) or radiofrequency ablation (RFA). The cost is determined based on the assessed complexity category of the procedure. During the initial consultation with diagnostics, the doctor determines the complexity category and the final cost of the upcoming surgery. The price includes medical compression stockings of class II compression.

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Patient Reviews

Over the years, our center has established key principles of care — exceptional professionalism, a personalized approach to each patient, multi-level diagnostics, high-quality varicose vein treatment, and full responsibility for the final outcome.

All Reviews

Lesia Chorna

July 9 2021

I recently had surgery performed by Serhii Petrovych.
To be honest, I was quite nervous before the procedure. While already on the operating table, I got scared that I might not be able to go through with it. But thanks to the doctor’s professionalism — and, I believe, his ability to sense how I was feeling — everything went quickly and almost imperceptibly. Dr. Shchukin Serhii Petrovych skillfully started a conversation about life, gently drew me into it... and just like that, the surgery was over.
A huge THANK YOU!!!
I hope the recovery process will be just as smooth and unnoticeable.
Once again — THANK YOU!!!

Yuliia Syniakova

December 14 2024

Vascular surgeons from the Phlebos Medical Center for Phlebology and Aesthetic Medicine took part as speakers on the topic “Management of Patients with Recurrent Varicose Veins.”

Olena Durytska

October 21 2022

I’m very glad that, on a friend’s recommendation, I ended up at this clinic for my surgery, which took place on 28.10.21.
A wonderful team — and Dr. Honcharov V.L., a young specialist who truly knows his field. Attentive and professional medical staff. I especially appreciated that the doctor thoroughly answered all of my questions, both before and during the procedure.
During the surgery, when I was feeling nervous, the nurses and medical assistant Dmytro helped calm me down.
I sincerely thank you for creating such a warm and reassuring atmosphere during the operation — something that is always stressful for any patient.
When you come to this clinic, you can truly feel that your health and comfort matter.
Now I’m in the post-operative period, under the attentive care and clear guidance of the doctor.
Wishing you continued success, growth, and many grateful patients!

Our doctors

Modern and effective treatment of varicose veins is provided by a team of vascular surgeons with extensive practical experience.

All doctors

Shchukin Serhii Petrovych

Experience: 28 years
Medical Specialty:
Chief Physician, PhD in Medicine, Top-Category Vascular Surgeon, Phlebologist, and Ultrasound Diagnostics Specialist

Honcharov Vyacheslav Leonidovych

Experience: 11 years
Specialization:
Vascular Surgeon, Ultrasound Diagnostics Specialist, Phlebologist

Alikberov Yurii Viktorovych

Experience: 18 years
Specialization:
Surgeon, Proctologist of the Highest Category

Frequently Asked Questions About Miniphlebectomy

Is the procedure painful?

Выполнение минифлебэктомии производится под местной анестезией, считается малоинвазивной, которую можно выполнять в амбулаторных условиях. Возможны болевые ощущения от введения анестезии.

How long does the procedure take?

Is hospitalization required?

Are there any scars left?

When can I return to normal activity?

Can there be a recurrence?

Licenses and Certificates

The Phlebology and Aesthetic Medicine Center “Phlebos” operates in accordance with Ukrainian legislation and holds a state license and official permits.