What’s the best varicose vein treatment in 2024? Before 1985, surgery was the only option for varicose veins. But today, with the advent of laser, radiofrequency, and infusion catheters, there are more treatment options than ever before.
Radiofrequency and Laser Ablation are generally considered the gold standard varicose vein treatments. However, as every case is different and every patient reacts differently to the various treatments, there is no clear-cut “best option”. What is clear-cut is that there will be a treatment that is the best option for you – depending on vein diameter, location, and your overall condition.
What are the different varicose vein treatment options?
As we mentioned, today, there are plenty of ways to treat varicose veins. These include:
- Endovenous Laser Ablation
- Radiofrequency Ablation
- Medical Superglue (VenaSeal, VenaBlock, VeinOFF)
- Sclerotherapy
- ClariVein
- Surgical Stripping
- Ambulatory Phlebectomy or Transilluminated Phlebectomy
What is the best varicose vein treatment in 2024?
Endovenous Laser Ablation (EVLA)
We insert a catheter with a laser tip into your vein. Guided by ultrasound technology, we seal the varicose vein through heat energy. Your body will then reroute blood flow to nearby healthy veins and absorb the varicose one, making it “disappear” in a few weeks.
EVLA for varicose veins is a state-of-the-art procedure with an extremely high (~98%) success rate. Laser treatment also has a very low recurrence rate (~5% over 5 years) and is relatively pain-free. EVLA is best used on larger varicose veins (particularly the saphenous or trunkal veins) as the laser fibre won’t be able to manoeuvre through small surface veins. This is why EVLA is frequently used with sclerotherapy for complex vein clusters.
EVLA is generally well-tolerated and widely considered safer than surgery. However, you may experience some mild bruising and aches in the first week post-treatment. There is also a small risk of numbness below the knee, though it will not be permanent.
Radiofrequency Ablation (RFA)
This treatment follows the same principle as laser ablation. But instead of heat energy, we seal the vein through a few radiofrequency bursts.
- Pros: Like EVLA, RFA is a gold-standard procedure with an extremely high success rate and a very low recurrence rate.
- Cons: Some mild bruising and aches in the first week post-treatment, though the risk is lower than in EVLA.
Medical Superglue
Here, we glue the problem vein shut. We Inject a medical-grade glue into the problem vein through a syringe or a catheter (depending on the vein’s size). Then, we apply gentle pressure to press and glue the vein closed.
VenaSeal treatments are excellent for treating average-sized veins. They are also quick and efficient. Generally, medical superglue is better suited for older patients. It is not suitable for those with a cyanoacrylate allergy.
Vein glue has shown good success rates (90%+) in clinical studies, though we need more data to compare its long-term effectiveness with ablation and phlebectomy accurately.
Sclerotherapy (liquid and foam)
In this procedure, we inject a sclerosant into the varicose vein. For small veins, liquid sclerotherapy is sufficient. For slightly larger ones, we use foam sclerotherapy under ultrasound guidance (UGFS). Sclerotherapy works by agitating the vein’s lining, causing sclerosis – a hardening of the vein wall that blocks blood flow.
Sclerotherapy is a simpler procedure than EVLA and RFA. It rarely requires regional anaesthesia and is well-tolerated. However, it is less effective when used on its own (80% success rate). It also carries the risk of an allergic reaction.
ClariVein
ClariVein also uses sclerosant. However, in this procedure, we inject it into the vein through the special ClariVein Catheter. Its 360-degree rotating tip allows us to get sclerosant deeper into the vein, making it suitable for larger veins than UGFS allows.
As with regular sclerotherapy, there is a slight risk of an allergic reaction.
Surgical ligation and stripping
Unlike the other treatments, surgical stripping involves manually removing the varicose vein. This treatment method is falling out of fashion, as research over the past few years shows that after a surgeon strips a vein, another vein grows in its place – frequently without vein valves, which results in another varicose vein forming soon after.
Stripping is also much more invasive than non-surgical procedures like EVLA and Sclerotherapy. As a result, you’ll be subject to more and larger incisions, a longer recovery, risks associated with general anaesthesia, and usually an overnight hospital stay.
Ambulatory and transilluminated phlebectomy
Ambulatory phlebectomy (also known as stab phlebectomy) involves making a series of small incisions along a varicose vein and removing it piece by piece.
In transilluminated phlebectomy, on the other hand, your surgeon will illuminate the varicose vein through a thin lighting device. They will use the light as a guide to pull through a wire with a special blade at the tip. The tip cuts up the varicose vein from the inside, which the surgeon then suctions out.
Specialists typically reserve these treatments for patients with very large and twisted varicose veins – especially cases where the veins result in complications like venous ulcers or deep vein thrombosis.
The benefit of these treatments is they’re less invasive than stripping, with ambulatory phlebectomy resulting in a shorter recovery. However, they are still more invasive than EVLA and RFA and may require an overnight hospital stay.
How do I know which varicose vein treatment is best for me?
The best treatment option for you depends on a few factors:
- Vein size: Laser, Surgery, and Radiofrequency ablation are best suited for large varicose veins; Superglue, ClariVein, and foam sclerotherapy for medium ones; and regular sclerotherapy for smaller ones.
- Allergens: As sclerotherapy and Medical Superglue treatments involve injecting a substance, you might get an allergic reaction. So before proceeding, we’ll need to do a test to see if you’re at risk.
- Speaking of risk, some treatments carry additional ones. For example, as Laser Ablation uses heat to seal the vein, there’s a minor chance it could damage surrounding nerves, leading to numbness, tingling, or pain. Laser Ablation and superglue might also create a blood clot, which, when stuck, can disrupt blood flow. And could be dangerous if dislodged. Surgery poses the most risk, with infection, nerve damage, blood loss, and more significant clotting.
Tips for selecting the best treatment provider
Choosing the right treatment isn’t just about which procedure to go for. Where you have it done and who does it should also be a consideration. To make sure you’ve got the best treatment for your veins, here are a few tips on what to look for.
- Reputation: Is the clinic well-reviewed? When previous patients have been happy and satisfied, it’s a great sign.
- Case Load: Do the doctors perform these procedures daily?
- Credentials: Are the doctors who perform the treatment well qualified?
- Environment: Is the clinic clean and comfortable? Friendly staff and a clean, comfortable clinic make a huge difference to the overall experience of the treatment.
- Second opinion: Are you unsure if what the clinic told you was reliable? Speaking to another clinic or doing more research at home to confirm the details you received is a helpful way of being sure.
Seek expert advice
In short, there is no ‘best treatment for varicose veins;’ there is only the best treatment for you. To determine what that is, you’ll need to seek expert advice. We offer in-depth consultations where we’ll go over your medical history, take an ultrasound scan of your legs to see how large the veins are and do an allergen test.
So if you’re ready to take the next step, call us at 04 2010 2637 or request a booking online.