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Evidence to Improve Care

Endovascular Laser Treatment and Radiofrequency Ablation for Varicose Veins

Ontario Health Technology Advisory Committee Recommendations

  • Endovascular laser treatment and radiofrequency ablation are safe, less invasive and cost-effective alternatives to surgical vein stripping that should be made available to people with symptomatic varicose veins and saphenous venous reflux demonstrated on a full duplex ultrasound investigation and, when feasible, following a failed trial of conservative management.

  • There is an absolute medical necessity for a surgical approach including radio frequency ablation or endovascular laser treatment of varicose veins associated with venous ulcer, thrombophlebitis, or bleeding. However, the decision to recommend a similar treatment approach based on other symptoms attributed to chronic venous reflux should be made on an individual basis and guided by validated disease severity scales such as the Venous Clinical Severity Score.

Read the full OHTAC Recommendation report

Varicose veins are enlarged or twisted veins caused by damaged valves that let blood flow backwards (a condition called reflux). Some varicose veins cause swelling, skin problems and ulcers (sores) and may need surgery to remove the damaged veins.

Health Quality Ontario Reviews Endovascular Ablation for Varicose Veins

Endovascular treatments are less invasive than surgery. They use radio waves and lasers to shrink or destroy the damaged part of the vein. These treatments can be done in clinics rather than hospitals and require less recovery time.

Endovascular Radiofrequency Ablation for Varicose Veins: An Evidence-Based Analysis (PDF)
February 2011

Related Reports

Endovascular Radiofrequency Ablation for Varicose Veins: OHTAC Recommendation (PDF)
January 2011 (Updated July 2013)

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The Ministry of Health and Long-Term Care is currently reviewing this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: A safe and effective surgical procedure for addressing symptomatic varicose veins and saphenous venous reflux is available and insured in Ontario. Endovascular laser treatment and radiofrequency ablation represent equally effective alternatives to this surgery, and are currently available only in private clinics in the community. The Ministry is considering whether pursuing funding and policy changes to publicly fund these new procedures is appropriate at this time given constrained fiscal resources.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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