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Alternative Treatments

For the majority of patients, thermal ablation (such as EVLA or radiofrequency) is the best form of varicose veins treatment, suitable for almost all cases. There is extensive literature from scientific studies, demonstrating excellent clinical results, an almost perfect safety record and durability of the results over many years. It is for this reason that NICE recommends that all varicose veins are treated this way.

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EVLA does, however, have one drawback. You as the patient must undergo local anaesthetic to ensure that you feel no pain during the heating process. This anaesthetic is delivered through needles, and although these are tiny, and although in our hands most patients tolerate the procedure very well, there are some patients who are seriously needle-phobic. Over recent years, two new techniques have been developed, which can painlessly ablate veins and hence do not require the local anaesthetic. These are Clarivein and Sapheon (Superglue) – both of which are available at a varicose vein clinic near you.

About Clarivein

Clarivein works by a combination of a rotating wire, which scratches the vein wall and at the same time a chemical sclerosant is injected. This combination works better than sclerosants alone. All of this is carried out through just one tiny skin puncture and is painless.

Watch a video of the Clarivein procedure here.

About Sapheon

Sapheon (Superglue) relies on sticking the walls of the vein together, using a medical-grade Superglue. This, too, is carried out through just one tiny skin puncture, and the procedure is painless.

A recent study, published in the Journal of Vascular Surgery, has demonstrated good results. (Twelve-Month Follow-up of the European Multicenter Study on Cyanoacrylate Embolization of Incompetent Great Saphenous Veins; Journal of Vascular Surgery: Venous and Lymphatic Disorders 2014; 2(1):1 p105–106)


What’s the snag? Why not use these techniques routinely?

All vein-treatment techniques have their own advantages and disadvantages, as well as their own risks. Each patient must be carefully assessed and then decide for themselves, on the basis of the evidence in their case, which technique is best for them.

All patients and all veins are different. Not all veins are suitable for these treatments.

Although these two new methods avoid the discomfort of the local anaesthetic needles, there can be some pain after the procedure, particularly with Superglue, from phlebitis.

Perhaps the biggest downside, however, is the limited evidence of long-term effectiveness and safety compared with thermal ablation. We do not know for sure yet whether these techniques are as effective, as durable or as safe as EVLA.

Almost inevitably, these techniques are also more expensive than EVLA – although our prices are still the most competitive of any in the UK.

Read about these techniques, watch the videos, discuss with us by phone or at an in-person consultation – and decide, with our guidance, which technique you would prefer. Whichever you decide, you are in good hands!

About Cermavein (Steam)

Steam (Cermavein) is yet another novel technique. It is the use of steam passed down the catheter instead of a laser fibre. At first glance, this may seem like a promising option, but the technique still requires the local anaesthetic injections, so it offers no advantage over EVLA. There are several disadvantages:

  • The results of early studies are not nearly as impressive as EVLA
  • No long-term results have been published
  • Although it may appear to be a cheap option, the devices used are far more expensive than EVLA devices

For these reasons, we do not recommend Steam as a sensible option for varicose veins treatment, and we do not offer it in any of our clinics.

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