Is surgery really necessary for varicose veins?

Are endovenous laser ablation and radiofrequency ablation suitable for varicose veins in the upper part of the thigh? I consulted my surgeon for alternative techniques, he said sclerotherapy would not work. Would these other two methods be suitable?

Answers from doctors (9)


Mid-Atlantic Institute of Venous and Lymphatic Medicine

Published on May 17, 2018

It depends on the venous reflux ultrasound results, severity of symptoms, distribution of varicose veins in the thigh, like inner thigh or front and outer thigh, duration of reflux at the sapheno-femoral junction, great saphenous and accessory saphenous vein, and cosmetic concerns.

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Answered by Mid-Atlantic Institute of Venous and Lymphatic Medicine

It depends on the venous reflux ultrasound results, severity of symptoms, distribution of varicose veins in the thigh, like inner thigh or front and outer thigh, duration of reflux at the sapheno-femoral junction, great saphenous and accessory saphenous vein, and cosmetic concerns.

Published on Jul 11, 2012


Hratch Karamanoukian, MD, FACS, RVT, RPVI , RPhS

Published on May 17, 2018

There is a misconception that endovenous therapy treats varicose veins. LARGE varicose veins need to be treated with microphlebectomy which is a surgical procedure which is best done by those that have surgical training. Small veins are treated by sclerotherapy. Find someone who does all the different types of procedures and he/she will give you the best guidance and most appropriate therapy.

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Answered by Hratch Karamanoukian, MD, FACS, RVT, RPVI , RPhS

There is a misconception that endovenous therapy treats varicose veins. LARGE varicose veins need to be treated with microphlebectomy which is a surgical procedure which is best done by those that have surgical training. Small veins are treated by sclerotherapy. Find someone who does all the different types of procedures and he/she will give you the best guidance and most appropriate therapy.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Oct 10, 2010

EVL and RO are suitable for varicose veins in the upper thigh if there is reflux in the upper saphenous system or feeding veins. Once the reflux is treated then the varicose veins can be treated by either microphlebectomies or foam sclerotherapy.If there is no reflux, then microphlebectomies or sclerotherapy may be done alone.

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Answered by Vanish Vein and Laser Center

EVL and RO are suitable for varicose veins in the upper thigh if there is reflux in the upper saphenous system or feeding veins. Once the reflux is treated then the varicose veins can be treated by either microphlebectomies or foam sclerotherapy.If there is no reflux, then microphlebectomies or sclerotherapy may be done alone.

Published on Jul 11, 2012


General Vascular Surgery Group

Published on Feb 26, 2010

Yes this is generally a good treatment for these varicose veins.

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Answered by General Vascular Surgery Group

Yes this is generally a good treatment for these varicose veins.

Published on Jul 11, 2012


Vein & Cosmetic Center of Tampa Bay

Published on Oct 19, 2009

Endovenous laser ablation and Radiofrequency ablation are both suitable for varicose veins in the upper part of the thigh if they are straight trunks such as a dilated greater saphenous vein. We have been performing ultrasound guided sclerotherapy for over 18 years and have found that we can close even extremely large varicose trunks with injection sclerotherapy under ultrasound.

Our preferred treatment is CoolTouch Endolaser for the primary, straight saphenous trunks followed by ultrasound guided foam injections for the tortuous varicose branches that come off of these trunks to complete the treatment.

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Answered by Vein & Cosmetic Center of Tampa Bay

Endovenous laser ablation and Radiofrequency ablation are both suitable for varicose veins in the upper part of the thigh if they are straight trunks such as a dilated greater saphenous vein. We have been performing ultrasound guided sclerotherapy for over 18 years and have found that we can close even extremely large varicose trunks with injection sclerotherapy under ultrasound.

Our preferred treatment is CoolTouch Endolaser for the primary, straight saphenous trunks followed by ultrasound guided foam injections for the tortuous varicose branches that come off of these trunks to complete the treatment.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Oct 15, 2009

Endovenous ablation is appropriate if there are leaking valves in saphenous system. If however, your Saphenous system is normal, then sclerotherapy may be more appropriate. Sclerotherapy for smaller veins. Foam sclerotherapy is also very effective in the treatment of larger varicosities.

Answered by Laser Vein Center (View Profile)

Endovenous ablation is appropriate if there are leaking valves in saphenous system. If however, your Saphenous system is normal, then sclerotherapy may be more appropriate. Sclerotherapy for smaller veins. Foam sclerotherapy is also very effective in the treatment of larger varicosities.

Published on Jul 11, 2012


Heart and Vein Center

Published on Oct 08, 2009

For the most part, for the large veins of the thigh endovenous laser or radiofrequency ablation are the methods of choice.

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Answered by Heart and Vein Center

For the most part, for the large veins of the thigh endovenous laser or radiofrequency ablation are the methods of choice.

Published on Jul 11, 2012


The Jacksonville Vein Center

Published on Sep 30, 2009

Endovenous ablation is appropriate if there are leaking valves in saphenous system. If however, your Saphenous system is normal, then phlebectomy or sclerotherapy is appropriate. Micro-phlebectomy is an effective treatment for larger veins and sclerotherapy for smaller veins. Foam sclerotherapy is also very effective in the treatment of larger varicosities.

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Answered by The Jacksonville Vein Center

Endovenous ablation is appropriate if there are leaking valves in saphenous system. If however, your Saphenous system is normal, then phlebectomy or sclerotherapy is appropriate. Micro-phlebectomy is an effective treatment for larger veins and sclerotherapy for smaller veins. Foam sclerotherapy is also very effective in the treatment of larger varicosities.

Published on Jul 11, 2012


Miller Vein

Published on Sep 23, 2009

Endovenous laser or radiofrequency ablation may be suitable to treat the refluxing (leaking) vein. The most important issue is to know which vein is refluxing and how long the segment is. The vein that is leaking is typically not visible to the naked eye & that's why an ultrasound is performed. This refluxing vein attaches to and causes the varicose veins which could be treated by either microphlebectomy or sclerotherapy. One of the advantages of microphlebectomy is that it requires only one treatment (sclerotherapy usually several).

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Answered by Miller Vein

Endovenous laser or radiofrequency ablation may be suitable to treat the refluxing (leaking) vein. The most important issue is to know which vein is refluxing and how long the segment is. The vein that is leaking is typically not visible to the naked eye & that's why an ultrasound is performed. This refluxing vein attaches to and causes the varicose veins which could be treated by either microphlebectomy or sclerotherapy. One of the advantages of microphlebectomy is that it requires only one treatment (sclerotherapy usually several).

Published on Jul 11, 2012


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