If EVLA is not the best treatment option for me, what would be? For the vast majority of patients, EVLA is the appropriate treatment. There are other treatments available, more modern treatments. The intention of these other treatments is to avoid the need for local anaesthetic injections. This is because if any part of the EVLA procedure is going to be a discomfort to the patient it is the injections of the local anaesthetic. There are two main new techniques used for those that really don’t like the idea of the injection needles. These are Clarivein: a technique involving a little motor-driven rotating wire, and an injection of sclerosant simultaneously to that. This just involves one needle puncture into the vein. The other technique is called superglue which is, as the name suggests, glueing together the walls of the vein. The problem with the superglue technique is that it’s very expensive and most patients would rather not spend an additional £1000 to avoid having a few needles for the local anaesthetic.