Ambulatory phlebectomy is an outpatient procedure typically performed under local anesthesia. It is for large, bulging varicose veins that persist after a refluxing vein has been closed. Tiny incisions are made and the varicose veins are removed. Typically, no stitches are required, and most patients return to work the next day. Heart and Vascular Care has been recognized for offering high quality outpatient vein treatment by the Accreditation Association for Ambulatory Health Care (AAAHC).