My doctor suggested radiofrequency ablation over EVLT because I have large veins, is this argument valid?

My vein doctor said radiofrequency ablation would be better than laser (EVLT) because I have such large veins. I read a lot about radiofrequency ablation and it seems a good option, but is the "big veins" argument valid?

Answers from doctors (12)


More About Doctor David Green, MD

Published on Mar 09, 2022

While both RFA (radiofrequency) and EVLT (endovenous laser) can be used, I agree that for larger veins there will be greater rate of success with RFA.

Answered by David Green, MD (View Profile)

While both RFA (radiofrequency) and EVLT (endovenous laser) can be used, I agree that for larger veins there will be greater rate of success with RFA.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Aug 10, 2018

I am not aware of any studies which suggest RF ablation is better that EVLT on larger veins. In fact, I believe EVLT is more widely used. It may be your doctor's preference. Statistically there is little difference between the modalities. I would be more focused on your doctor's experience and vascular surgery training/experience.

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Answered by Vein Specialties of St. Louis

I am not aware of any studies which suggest RF ablation is better that EVLT on larger veins. In fact, I believe EVLT is more widely used. It may be your doctor's preference. Statistically there is little difference between the modalities. I would be more focused on your doctor's experience and vascular surgery training/experience.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Dec 05, 2014

This is an invalid argument. Both laser and RF work well with large veins . There are techniques that are used to decrease the size of the veins during the procedure.

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Answered by Vanish Vein and Laser Center

This is an invalid argument. Both laser and RF work well with large veins . There are techniques that are used to decrease the size of the veins during the procedure.

Published on Jul 11, 2012


Artery and Vein Specialists of Idaho

Published on Apr 17, 2014

In my experience, this is absolutely reversed thinking, as EVLT is better on larger veins than RF.

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Answered by Artery and Vein Specialists of Idaho

In my experience, this is absolutely reversed thinking, as EVLT is better on larger veins than RF.

Published on Jul 11, 2012


Finesse Surgical Solutions

Published on Mar 17, 2014

I use both energy sources for endovenous ablation. I have had excellent success using laser EVLT to close large veins (up to 3cm). Success with RF is also very good. Some clinics only use one or the other energy source.

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Answered by Finesse Surgical Solutions

I use both energy sources for endovenous ablation. I have had excellent success using laser EVLT to close large veins (up to 3cm). Success with RF is also very good. Some clinics only use one or the other energy source.

Published on Jul 11, 2012


In my opinion, EVLT and ablation are both good options for "large veins". The ablation, in my experience, causes less skin damage and post-procedure discomfort. Our office uses ablation exclusively. Ultrasound guided sclerotherapy is not as effective on larger veins compared to EVLT/ablation. I believe the closure rates are comparable for EVLT and ablation. Ablation being a little better at 98%. Hope that answers your question!

Answered by HeartCare Associates Vein Center (View Profile)

In my opinion, EVLT and ablation are both good options for "large veins". The ablation, in my experience, causes less skin damage and post-procedure discomfort. Our office uses ablation exclusively. Ultrasound guided sclerotherapy is not as effective on larger veins compared to EVLT/ablation. I believe the closure rates are comparable for EVLT and ablation. Ablation being a little better at 98%. Hope that answers your question!

Published on Jul 11, 2012


Vein Center of Orange County

Published on Mar 06, 2014

You are an astute consumer. Both laser and radiofrequency are equally effective methods for thermal ablation of saphenous veins, providing well over 90% success. If a newer high-frequency (>1100 nm) laser is used, this will provide similar post-treatment discomfort and bruising, which is minimal. Trusting your doctor is more important than which method is used to heat the vein regardless of vein size.

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Answered by Vein Center of Orange County

You are an astute consumer. Both laser and radiofrequency are equally effective methods for thermal ablation of saphenous veins, providing well over 90% success. If a newer high-frequency (>1100 nm) laser is used, this will provide similar post-treatment discomfort and bruising, which is minimal. Trusting your doctor is more important than which method is used to heat the vein regardless of vein size.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Mar 06, 2014

Yes.

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Answered by Cosmetic Vein Centers of Texas

Yes.

Published on Jul 11, 2012


Vein Care of New Mexico

Published on Mar 06, 2014

No.

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Answered by Vein Care of New Mexico

No.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Mar 05, 2014

While I think both radiofrequency ablation RFA and laser (EVLT) ablation
are good treatment. I think the "big veins "argument for RFA is not a valid
one .

Answered by Laser Vein Center (View Profile)

While I think both radiofrequency ablation RFA and laser (EVLT) ablation
are good treatment. I think the "big veins "argument for RFA is not a valid
one .

Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on Mar 05, 2014

No. Actually laser might be more effective in the largest of veins but likely that is what he ownes.

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Answered by Bella MD Laser Vein and Aesthetic Center

No. Actually laser might be more effective in the largest of veins but likely that is what he ownes.

Published on Jul 11, 2012


Veins etc. at Comprehensive Cardiovascular Consultants

Published on Mar 05, 2014

Not clear. Both are good options. Lasers are more powerful and can be more helpful in larger veins, but the difference is small.

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Answered by Veins etc. at Comprehensive Cardiovascular Consultants

Not clear. Both are good options. Lasers are more powerful and can be more helpful in larger veins, but the difference is small.

Published on Jul 11, 2012


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