“We now use three main methods of vein destruction; laser ablation (EVLT), RF ablation (VNUS Closure®) and foam sclerotherapy. Although the medium and long term results of VNUS Closure® and laser ablation (EVLA) are identical there do appear to be minor advantages of VNUS Closure® in some patients. There is almost no bruising whereas with laser expect some up to 2 weeks. There is almost no pain after the procedure whereas with laser some patients do experience some discomfort usually at 5 days but this is very rarely significant or bad enough to prevent all normal activities. The disadvantage of VNUS Closure® is that it costs £200 more than laser as the disposable tools are more expensive to purchase. We use VNUS Closure® ablation also for the treatment of incompetent perforators (TRLOP). Although some doctors treat large veins by injections (foam sclerotherapy) the results are not as effective or as durable as either EVLA or VNUS Closure®  and we do not recommend this. We do use foam sclerotherapy for any residual varicosities remaining at follow-up after either the EVLT or VNUS Closure® treatment. Both techniques rely on accurate preop mapping of anatomy and blood flow by colour duplex ultrasound and use of ultrasound to guide the instruments during the procedure. A full explanation of the treatment options including potential complications and success rates will have been given at an earlier consultation. You will have been asked to sign to give your consent to the treatment proposed, you will be introduced to the nurse or radiographer who will be at your side throughout the procedure, which will take place in a small treatment room. Music of your choice will be available if you wish. We have an i-pod amplifier that you can plug your own i-pod into if you wish.