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Evidence to Improve Care

Nonthermal Endovenous Procedures for Varicose Veins

Final Recommendation

  • Ontario Health, based on guidance from the Ontario Health Technology Advisory Committee, recommends publicly funding endovenous procedures for symptomatic varicose veins

Read the final recommendation report


Varicose veins are enlarged, twisted veins that are visible under the skin, often in the legs. They are a sign that the circulation of blood in the legs is impaired. People with varicose veins may experience aching, burning, swelling, skin colour changes, or more severe complications including bleeding and open wounds.

In those with substantial symptoms, surgery to remove the problem veins has been the traditional treatment. Newer, less invasive procedures use either laser or radiofrequency heat inside the veins (endovenous) to burn them closed. These thermal endovenous procedures can be done in a doctor’s office instead of an operating room, but they still require local anesthesia. There is interest in nonthermal (not heat-based) alternatives. The nonthermal endovenous methods are called cyanoacrylate adhesive closure, which uses a medical glue to close varicose veins, and mechanochemical ablation, which uses a combination of physical and chemical methods to close the problem veins.

This health technology assessment looked at how safe, effective, and cost-effective nonthermal endovenous procedures are for people with symptomatic varicose veins. It looked at the budget impact of publicly funding thermal and nonthermal endovenous procedures. And it looked at the experiences, preferences, and values of people with varicose veins.

Read the full health technology assessment report for more information.


Nonthermal Endovenous Procedures for Varicose Veins: A Health Technology Assessment (PDF)
June 2021

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The Ministry of Health is currently reviewing this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review health technology assessments and funding recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.



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