Ambulatory Phlebectomy

An Ambulatory Phlebectomy is an office procedure performed to remove large surface varicose veins through tiny skin punctures. It leaves minimal scarring and is performed under local anesthesia. There is very little discomfort and no stitches are required.


There may be minimal discomfort after the procedure which may be relieved by anti-inflammatories and leg elevation.


Plan to be at our office for 2-4 hours. This is dependent upon the number of varicosities to be removed.

Your leg will be wrapped with gauze and ace wraps for 3 days post-procedure. On the third day you will remove the wraps. Plan to relax and elevate your affected leg intermittently with periods of walking for the 3 days after your procedure.

Pre-Procedure Instructions

Pre-Procedure Instructions

Please consider and follow these pre-procedural instructions prior to your procedure at the Vein Center at Iowa Heart.


Ambulatory Phlebectomy is performed in our office under local anesthesia. You will receive medication to help you relax, so please make arrangements for a responsible adult driver to drive you home.

Bring some pillows in the car for the ride home. We want you to elevate your affected leg in the car to minimize bleeding risks.

Food and Medication

Minimal food or drink is recommended the morning of the procedure to enhance absorption of the medication. A light breakfast or snack is acceptable. Take your normal medications. If your procedure is scheduled in the afternoon, a light lunch is acceptable.

If you are on a blood thinner, please notify us immediately so that if needed, we may speak with your primary physician and determine a course of action.

What to Wear

Wear loose fitting, comfortable clothing.


Please check with your insurance company prior to your procedure to assure that your Ambulatory Phlebectomy procedure is a covered benefit with your individual plan. This will be billed as an office procedure. Please ask that they quote your financial responsibilities.

The Current Procedural Terminology (CPT) code for Ambulatory Phlebectomy is 37765 or 37766.

If your insurance company states that you need a preauthorization, please notify our office. Our office will preauthorize any procedure and notify you when you are approved. We can then schedule your procedure.

Other Instructions

In preparation for the procedure, we request that you maintain a standing position as much as possible for 2 hours prior to arrival. This will help to increase the circulation to your legs, thus increasing the ease of the procedure.

Post-Procedure Instructions

Post-Procedure Instructions

Now that your procedure is complete, you may resume normal activities with the following exceptions and suggestions.

Immediately Following the Procedure

After the procedure, keep your leg elevated as much as possible until bedtime. You may get up to use the restroom or to get something to eat.

If your toes turn blue and/or feel numb, loosen the ace wrap and reapply. If this doesn’t improve, call the office.

If bleeding soaks through the bandage, keep the leg elevated and apply firm pressure for five to ten minutes or call the nurse. Keeping your leg elevated above the level of the heart will minimize the risk of bleeding.


Keep the dressing dry. Do not shower or get the dressing wet. You may shower after the bandages are removed.

No baths or soaking in water for 2 weeks. This includes swimming pools, hot tubs, and lake or river water exposure. Avoid UV rays for 4-6 weeks after procedure.

Pain Management

You may or may not experience discomfort or pain after the procedure for up to several weeks. An over-the-counter anti-inflammatory medication is recommended. You will also be given a prescription for a pain medication if indicated.


Tomorrow, start walking 4-5 times a day for 10 minutes and alternate with intermittent elevation. The next day, increase walking to several times a day with intermittent elevation.

Gradually increase activity as tolerated. No weight lifting with the affected leg for 2 weeks. No running or vigorous aerobic activity for 2 weeks.


Bandages will remain on for 3 days after the procedure. You may then remove the bandages and shower. If steri strips are applied, do not remove the strips. It’s okay to get these wet. They can be removed as they begin to fall off. If necessary, reapply a small bandage such as a band-aid or gauze.

Questions or Concerns?

Contact the Vein Center at Iowa Heart office at 515-633-3666 or toll-free at 877-413-VEIN.

West Des Moines Office Hours 8:00 am – 4:30 pm, Monday – Friday

As a courtesy to our staff and other patients, if you need to cancel or reschedule your procedure for any reason, please do so at least one week prior to your scheduled appointment.

Am I a Candidate?

Determine if you are at risk for developing or already have symptoms for venous disease.