Vascular Surgery – Phlebology

Vascular Surgery - Phlebology

Venous insufficiency is a chronic disease that affects 1 in every 3 adults. It is characterized by a poor return of the blood into the lower limbs.

Vithas Xanit International Hospital has a Unit specialising in Endovascular and Vascular Surgery.

A physical examination- and a preoperative study with ecodoppler will determine the exact type of treatment for each patient. The ecodoppler is a non-invasive diagnostic technique that allows us to monitor blood flow, by translating it into an image.

In recent years, new minimally invasive techniques such as the diode laser have been introduced for the treatment of varicose veins. The medical team at Vithas Xanit International Hospital has extensive experience in these procedures.

The varicose treatments used at Vithas Xanit International Hospital are the following:

  • Esclerotherapy with microfoam of spider veins and telangiectasias
  • The ablation of internal saphenous with diode laser
  • Phlebectomy (varicose vein surgery)
  • C. H. I. V. A (hemodynamic surgery)

Vithas Xanit International Hospital also has facilities to perform minimally invasive surgery (MIS) of the peripheral arthropathy, which is system of arteries that transport the blood to the organs. These procedures include: angioplasty/stents, carotid endarterectomies, revascularization, bypass, treatment of aneurysms, etc…


Varicose veins in the lower limbs are abnormal and are permanent dilatations of veins, mainly in the superficial venous system.

This system is located under the skin and is made up of the saphenous veins and their branches. These dilatations are usually caused by a functional failure in the valves which results in upward flow of the blood which reaches the legs. When the valves fail, the blood flows backward due to gravity. This means that blood accumulates, and the varicose vein is created.

A varicose has no function and only creates problems for the patient (phlebitis, ulcers, heaviness, pain…).

The treatment focuses on eliminating the vein. variscose vein can be hereditary  and can also be caused when the patient spends many hours standing up or when they are overweight.

Vithas Xanit International Hospital adapts the treatment depending on the individual case. They take into consideration the severuty of the symptoms and adapt the treatment accordingly.


The sclerosis of the varix, or phlebosclerosis, is the sealing of a vein performed by injecting a sclerosing substance that irritates it and “dries out the varicose”. These injections are inserted using a very thin needle, thus minimising discomfort. This procedure does not requiring anaesthesia.

Reasons for sclerotherapy:
This is recommended when a small vein has dilated and may worsen thus forming a varicose vein: spider veins, telangiectasias, etc.

Sclerotherapy procedure:
This consists of injecting a small needle into the small varicose vein, which contains a sclerosing substance that causes fibrosis and hardening of the vein. In this way the vein will just disappear over the following weeks or months. The dosage of the injection depends on the type of vein and varicose. This treatment is carried out with sonographic control.

Type of treatment:
This is an outpatient varicose vein treatment which does not require anesthesia. Generally, several sessions are required to obtain the desired results.


The diode laser is used for endovenous ablation (ELVA) of the incompetent saphenous vein. A fibre laser is introduced into the vein which requires elimination. In this way it coagulates, without requiring removal. This technique allows the treatment of a large varicose vein without any incisions being made into the skin. Therefore there are no marks or scars as the varicose vein treatment is totally percutaneous. This procedure is performed in an operating theatre and in many case can be performed using only local anaesthesia.

Reasons for using diode laser:
With the endovascular laser we are able to treat medium, large, and very large varicose veins. It allows us to treat the externally visible branches as well as the saphenous vein and perforating veins.

Diode laser procedure:
This is a percutaneous technique. The fibre laser is introduced within the blood vessel through the vein using an intraoperative Doppler ultrasound.

Type of surgery and anesthesia:
The intervention is usually ambulatory and the patient can return home on the same day.

In certain cases and dependent on the type of varicose vein, the treatment can be combined with micro foam sclerotherapy.

During the intervention the doctor focuses on the dilated veins, which are the ones which can lead to medical complications. The residual spider veins can be treated afterwards during out-patient sessions if necessary.

This technique has completely replaced the old “Stripping method of extracting the saphenous vein” which was the classic method developed more than 50 years ago.  With the new technique, the patient does not have scarring, and there are none of the risks associated with an epidural or general anesthesia, damage to the nerves in the legs are minimised and the long-term results are better.


Reasons for a phlebectomy:
Oedemas and varicose veins in the lower limbs which causes heaviness and pain.

Phlebectomy procedure:
The phlebectomy or ambulatory venotomy is the resection of the dilated and unserviceable veins that are usually branching off from the perforating veins.
In these cases, the saphenous vein usually works properly so is not removed.  The surgeon cuts the varicose vein and extracts the fragment of dilated vein. Small fragments of veins are extracted using micro incisions which do not require stitches (1-2 mm).

Type of surgery and anesthesia:
The surgery usually lasts between 20 minutes and an hour. It is normally carried out under local anesthesia.
It is out-patient surgery.


This hemodynamic surgery allows the treatment of a varicose vein without destroying or extirpating the vein. It allows for the conservation of the superficial venous system and the saphenous vein.

Reasons for the C.H.I.V.A procedure
Oedemas and varicose veins in the lower limbs which causes heaviness and pain.

Varicose vein surgery procedure.
The CHIVA methods can stop the reflux of blood in the saphenous vein as  the blood flow is diverted to the deep venous drainage system.
Through small incisions the surgeon carries out ligatures at specific points along the saphenous vein, depending on the individual case. In this way the blood is taken into the deep venous system. By using this procedure, the saphenous vein is preserved and is able to function correctly.
This method is less invasive than the conventional surgery, and could be recommended in certain cases.

Type of surgery and anesthesia:
The surgery usually lasts between 30 – 45 minutes. It is normally carried out under local anesthesia. It is outpatient surgery.


1- Information and motivation for your vascular surgery

Within 24 hours of receiving your request for information, we will contact you by e-mail or phone to assess your needs, identify your reasons for surgery and to answer your questions directly.

2- Diagnosis and selection of the vascular surgery

We advise you to firstly visit our Vascular Surgery Department In order to ascertain which particular Varicose Vein treatment / surgical intervention is best suited to your individual case.

  • Medical records:
    We will send you a list of examination and medical tests results that we will will need to see during your first visit to Vithas Xanit International Hospital. In the event that our doctors deem necessary an additional screening test, this could be carried out during the same visit (except in the case of tests which require anaesthesia, in which case they will need to be pre-booked). You may send a copy of your medical information in advance before planning your first visit.
  • Diagnosis:
    The professionals involved in the diagnosis and treatment of vascular surgery will study your medical records, the result of tests and examinations, and will establish a precise and reliable diagnosis. We will assist you in choosing the type of vascular surgery which is best suited to your particular case.

We will provide you with complete information: treatment process, programming and a detailed quote.

3- Process for the varicose vein treatment

  • Vascular surgery protocol
    The process and the scheduling of the appropriate surgery varies dependent on the type of vascular surgery used in your particular case.
  • An assigned medical team
    Throughout your treatment process, you will always deal with the same team of doctors.

4- Your travel plan

Once your planned varicose vein treatment has been confirmed and accepted, our International Services Team at Vithas Xanit International Hospital will be at your disposal to assist you with the organising of your trip to Malaga and  will remain in constant contact with you.

5- Your arrival

Upon your arrival in Malaga, a representative of Vithas Xanit International Hospital will be waiting to greet you. We will help you organise your transfers and accompany you to our hospital.

6- Follow-up treatment – vascular surgery

  • Maintaining contact with you. Once you have been discharged our International Services Team will be at your disposal should you require any further medical assistance, and shall assist you with any administrative requirements that you may.
  • Informing your referring doctor. We shall provide you with a full medical report which you can give to your own doctor back home.

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