Transilluminated powered phlebectomy in an office setting: procedural considerations and clinical outcomes

To report a series of non-sedated patients treated with transilluminated powered phlebectomy (TIPP) under tumescent anesthesia in an office setting.

Thirty-six patients (31 women; mean age 54.8±11.8 years) with a mean body mass index of 25 kg/m(2) were selected for the in-office TIPP procedure between January 2009 and September 2010. Medical conditions included hypertension, asthma, hypothyroidism, and gastrointestinal problems. Twenty-eight had prior surgical procedures, 10 of which were for vascular abnormalities. Symptom duration was a mean of 19 years. Twenty-five had a family history of venous disease. The CEAP classification ranged from 2 to 4, but the majority were class 2. Seven patients had conditions that made the TIPP procedures more challenging. Medical data, preoperative venous status, postoperative findings, and patient-reported satisfaction were reviewed.

All procedures were completed as planned and without complications. The mean TIPP procedure time was 13.5±3.7 minutes. Thirty-three patients underwent concurrent endovenous ablation. Patient satisfaction measured on a scale from 0 to 10 ranged from a mean of 8.8 at 48 hours to 9.6 at 3 months. At the 3-month follow-up, there were no reports of hematoma, deep venous thrombosis, or extended paresthesia.

Appropriately selected patients with a variety of clinical presentations can safely undergo the TIPP procedure in an office setting utilizing only local tumescent anesthesia.