On the day of the mini-phebectomy, the patient will apply a topical numbing cream given to them by the VTC about two hours ahead of the appointment. The application of the numbing cream at home allows the patient to avoid idly sitting in the doctor’s office for an hour or more, waiting for the anesthetic cream to become fully active. After the two hour numbing period and the patient has arrived at the VTC office, Dr. Al-Misky will do a leg marking. This will provide a ‘map’ on the skin, showing on the body’s surface where the ultrasound visualization has shown where the problem vein and important ancillary veins are under the surface. Dr. Al-Misky then makes an injection of a local anesthetic under the skin, which is almost painless as the numbing cream has desensitized the tissue.

In a sterile setting, the patient is placed on the table. Another dose of local anesthesia, this time near the veins themselves, is injected under color duplex ultrasound guidance. Then the mini-phlebectomy begins as precise stab incisions are made into the veins to be excised. The procedure itself usually takes around a half hour to complete. When the procedure is complete the leg is wrapped with elastic bandages.