Varicose Vein Treatment: Transilluminated Powered Phlebectomy (TIPP)

Transilluminated Powered Phlebectomy (TIPP) is a type of varicose vein treatment that is considered an alternative treatment to ambulatory phlebectomy, also known as mini phlebectomy or stab phlebectomy. Both of these procedures are used to completely remove large superficial bulging veins, rather than ablate them as is done with sclerotherapy varicose vein treatment and endovenous laser treatment (EVLT). Please note that neither TIPP nor ambulatory phlebectomy is the same as the much older, and much more invasive, procedure of vein stripping where the great saphenous vein is removed through traditional surgery.

Transilluminated powered phlebectomy is used instead of sclerotherapy varicose vein treatment or EVLT when the varicose vein is extra large and the doctor does not think ablation would work well or the risk of a complication is too high. TIPP varicose vein treatment is also used in cases where the venous disease in the patient has advanced to the ulcer stage where the varicose veins are bleeding out.

During TIPP varicose vein treatment, a light is inserted beneath the skin that illuminates the varicose vein through the tissue, i.e. it’s transilluminated so it’s very easy for the doctor to see. Then, a special tube tool (a hand powered endoscopic tissue dissector), with a tiny rotating blade at the end, is used to cut the vein into tiny fragments and then suction through the tube is used to remove them. Just like with ambulatory phlebectomy, several tiny incisions are made along the length of the large varicose vein and the procedure is repeated until the entire vein is gone. In some cases, another portion of the same vein, or surrounding veins, may be ablated with sclerotherapy.

Unlike ambulatory phlebectomy, sclerotherapy, or EVLT, TIPP is sometimes performed under general anesthesia where the patient is put into an unconscious state. However, TIPP may also be performed with only local anesthesia but with the administration of a mild sedative to keep the patient calm and still. The type of local anesthesia is called tumescent anesthesia. This is where the anesthesia is administered directly into the vein, along the entire length of the vein upon which the procedure will take place. This not only numbs the area so there is no pain, it also hardens the vein, making it easier to remove.

Transilluminated powered phlebectomy is almost always done in association with EVLT since the EVLT procedure is used to fix the underlying venous reflux disease (where blood flows the wrong way through the vein) causing the big bulgy vein near the surface of the skin. This is why some insurance companies insist the EVLT be used first before they will cover the transilluminated powered phlebectomy

One major advantage that TIPP varicose vein treatment has over other types of varicose vein treatment, including ambulatory phlebectomy, is that it requires fewer tiny cuts to remove the vein. It’s also easier to remove several large varicose veins at one time with this procedure. The transilluminated light makes it easier to see the varicose vein(s) than is the case during ambulatory phlebectomy and other types of lessor known phlebectomy procedures.

There are some disadvantages of using Transilluminated Powered Phlebectomy instead of the more common ambulatory phlebectomy varicose vein treatment. Some patients will experience more significant pain and larger scale bruising after this procedure. This will make the healing process a bit more intensive and likely longer. However, when the healing process is over, transilluminated powered phlebectomy will have the same cosmetic appearance as you’d have with ambulatory phlebectomy.

In most cases, patients who undergo TIPP varicose vein treatment are able to return to work and or their normal routine within a week, often in a couple of days. However, they are instructed to refrain from heavy lifting, intense exercise, and standing or sitting in place for too long. However, walking is encouraged, as is usual with most types of modern day varicose vein treatment.

If you want to learn what type of varicose vein treatment(s) would be best suited for your specific condition, you can set up an appointment with Metro Vein Centers by simply calling the nearest location. You do not need to get a referral for a general appointment, although general practitioners often do refer patients to Metro Vein Centers. If you have large bulging veins near the surface of your skin and or you have leg ulcers or have had them in the past, some type of phlebectomy may be recommended. However, EVLT and sclerotherapy are far more popular treatments these days.