Muller’s phlebectomy^[*]

Summary

More than 50 years ago, the Swiss dermatologist Dr Robert Muller developed ambulatory phlebectomy, a brilliant demonstration of the major role of dermatologists in the field of phlebology. The technique is safe, reliable and cost-effective, while at the same time producing aesthetically pleasing results. Patients can usually resume normal daily activities immediately after the procedure or are off work for a few days at most. Indications for ambulatory phlebectomy include incompetent saphenous veins (except the junctions) and their tributaries, perforators, reticular veins and reticular feeder veins, large spider veins and dilated veins in other areas such as around the eyes, on the arms or on the back of the hands.

The tiny skin incisions do not usually leave any scars or give rise to complications. Phlebectomy can be used alone or in combination with other procedures such as sclerotherapy, endovenous techniques and surgery.

Keywords

Varicose veins - surgery - telangiectasia - spider veins - phlebectomy - tumescent anaesthesia - START therapy

• References

• 1 Ramelet AA. Phlebology: an essential part of dermatology. Dermatology 1998; 197 (02) 99-100.
• 2 Ramelet AA. In Memoriam Dr Robert Muller. Dermatologica Helvetica 2012; 24: 6
• 3 Olivencia JA. Interview with Dr. Robert Muller. Dermatol Surg 1998; 24: 1147-1150.
• 4 Muller R. Traitement des varices par la Phlébectomie ambulatoire. Bull Soc Fr Un Phlébol 1966; 19 (04) 277-279.
• 5 Muller R. La Phlébectomie Ambulatoire. Phlébologie 1978; 31 (03) 273-278.
• 6 Muller R. Mise au point sur la phlébectomie ambulatoire selon Muller. Phlébologie 1996; 49 (03) 335-344.
• 7 Ramelet AA. Ambulatory Phlebectomy.. In: Alam M, Silapunt S.. editors. Treatment of leg veins Philadelphia: Elsevier; 2010
• 8 Moro L, Serino FM, Ricci S, Abbruzzese G, Antonelli-Incalzi R. Dilution of a mepivacaine-adrenaline solution in isotonic sodium bicarbonate for reducing subcutaneous infiltration pain in ambulatory phlebectomy procedures: A randomized, double-blind, controlled trial.. J American Acad Dermatol. 2014. Epub 2014/07/16
• 9 Ramelet A-A. Phlébologie esthétique. Varices tronculaires et réticulaires. Cosmétologie et Dermatologie esthétique.. Paris: EMC (Elsevier Masson SAS, Paris); 2010
• 10 Gajraj H. Phlebectomy without surgical scars: a new technique. Phlebology 2011; 26 (06) 263.
• 11 de Roos KP, Neumann HA. Hematomas are underrepresented in studies on complications of ambulatory phlebectomy. Dermatol Surg 2002; 28 (06) 544-545.
• 12 Ramelet AA. Complications of ambulatory phlebectomy. Dermatol Surg 1997; 23 (10) 947-954.
• 13 Olivencia JA. Complications of ambulatory phlebectomy. Review of 1000 consecutive cases. Dermatol Surg 1997; 23 (01) 51-54.
• 14 Elvy M. Post ambulatory phlebectomy: chronic peripheral lymphocoele. Phlebology 2010; 25 (03) 158-160.
• 15 de Roos KP, Nieman FH, Neumann HA. Ambulatory phlebectomy versus compression sclerotherapy: results of a randomized controlled trial. Dermatol Surg 2003; 29 (03) 221-226.
• 16 Biemans AAM, van den Bos R-R.. Hollestein LM, Maessen-Visch MB, Vergouwe Y, Martino Neumann HA. et al. The effect of single phlebectomies of a large varicose tributary on great saphenous vein reflux. J Vasc Surg: Venous Lym Dis 2014; 2: 179-187.
• 17 Pittaluga P, Chastanet S, Locret T, Barbe R. The effect of isolated phlebectomy on reflux and diameter of the great saphenous vein: a prospective study. Eur J Vasc Endovasc Surg 2010; 40 (01) 122-128.
• 18 Ramelet A-A. Phlébologie esthétique. Télangiectasies : possibilités thérapeutiques.. Cosmétologie et Dermatologie esthétique.. Paris: EMC (Elsevier Masson SAS, Paris); 2010
• 19 Ramelet AA. Die Behandlung der Besenreiservarizen: Indikationen der Phlebektomie nach Müller. Phlebologie 1993; 22: 163-167.
• 20 Ramelet AA. Sclerotherapy in Tumescent Anesthesia of Reticular Veins and Telangiectasias. Dermatol Surg 2012; 38 (05) 748-751.
• 21 Ramelet AA. Die START Technik. Vasomed 2012; 24 (03) 156-157.
• 22 Ramelet AA. La technique START (Sclerotherapy in Tumescent Anaesthesia of Reticular Veins and Telangiectasias). Phlébologie 2012; 65 (02) 13-17.
• 23 Weiss RA, Ramelet AA. Removal of blue periocular lower eyelid veins by ambulatory phlebectomy. Dermatol Surg 2002; 28 (01) 43-45.
• 24 Ramelet A-A. Phlébologie esthétique : phlébectomie hors membres inférieurs.. Cosmétologie et Dermatologie esthétique.. Paris: EMC (Elsevier Masson SAS, Paris); 2011
• 25 Ricci S. Letter regarding article titled ’Transilluminated powered phlebectomy: a clinical report’. Phlebology 2009; 24 (04) 189
• 26 Ramelet AA. Maladie veineuse chronique sur anomalie de drainage veineux intraosseux : perforantes osseuses?. Phlébologie 2014; 67 (01) 78-80.