Choosing the Best Varicose Vein Treatment: Comparing EVLT, Surgical, and Sclerotherapy Options

Endovascular laser therapy, surgery, and sclerotherapy are three prevalent and effective methods for the treatment of varicose veins, a condition characterized by enlarged, twisted veins usually appearing in the legs. Each method offers unique approaches and benefits, and understanding their differences is crucial for selecting the most appropriate treatment. Click here to book an appointment now and find out more.

Endovascular Laser Therapy (EVLT)

Endovascular Laser Therapy, a minimally invasive procedure, has revolutionized varicose vein treatment. It involves the use of laser energy to close off the affected veins. A thin laser fiber is inserted into the vein through a small incision, usually under ultrasound guidance. Laser energy is then applied, causing the vein to collapse and seal shut. Over time, the body naturally absorbs the treated vein.

The major advantage of EVLT is its minimally invasive nature. It typically requires only local anesthesia, and patients can usually resume normal activities shortly after the procedure. The precision of laser technology allows for targeted treatment, minimizing damage to surrounding tissues. Its effectiveness is notable, with a high success rate and a low recurrence of varicose veins. However, potential risks include nerve damage, infection, or blood clots, though these are relatively rare.


Traditional surgery for varicose veins, known as ligation and stripping, is a more invasive approach. This procedure involves tying off the affected vein (ligation) and then removing it (stripping). The surgery is performed under general anesthesia and requires incisions at the site of the vein and possibly the groin or knee. Following the procedure, the blood reroutes through healthier veins.

Surgery is often recommended for larger varicose veins or when other methods are not suitable. The primary benefit is its thoroughness; it physically removes the problematic vein. However, the recovery time is longer compared to less invasive methods, and there are standard surgical risks, such as infection or scarring. With the advent of newer, less invasive techniques, the use of traditional surgery has decreased but remains a viable option in specific cases.


Sclerotherapy is a popular treatment, especially for smaller varicose and spider veins. It involves injecting a sclerosing solution directly into the vein, causing it to collapse and eventually fade away. The procedure is generally quick, performed in an outpatient setting with no need for anesthesia.

Sclerotherapy is highly effective for small to medium-sized veins and offers a relatively quick recovery with minimal discomfort. It’s also useful for treating veins that are not candidates for laser treatments. Side effects can include bruising, swelling, and in rare cases, allergic reactions to the sclerosing agent. Multiple sessions may be necessary for optimal results.

The choice between endovascular laser therapy, surgery, and sclerotherapy depends on various factors, including the size and location of the varicose veins, the patient’s overall health, and personal preferences. EVLT offers a balance between minimal invasiveness and effectiveness, making it a popular choice for many. Traditional surgery, though more invasive, is sometimes necessary for larger veins. Sclerotherapy remains a preferred method for smaller veins due to its simplicity and efficacy. Consulting with a vein specialist is essential to determine the most appropriate treatment, considering the individual characteristics and needs of each patient.

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