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

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The Ministry of Health endorses 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.

Evidence to Improve Care