Endovenous laser therapy and radiofrequency ablation of saphenous varicose veins

Radiofrequency ablation (RFA) and endovenous laser treatment (EVLT) are minimal invasive methods to treat saphenous varicose veins. The short- and mid-term results are excellent with an occlusion rate for RFA of almost 90% after 5 years and about 95% for EVLT after 2 years. Severe side effects are rare in both cases. Prospective randomised comparative studies are available for RFA and surgery showing comparable short-term results and superiority of RFA concerning short-term quality of life outcome. For laser treatment no prospective randomised comparative studies are available. Endovenous treatment is only a part of the complex treatment concept of varicose veins. Insufficient tributaries have to be treated in addition. The fact that the insufficient saphenous vein is treated without high ligation seems not to influence the short-term and midterm recurrence rates. More prospective randomised comparative studies comparing endovenous treatment and surgery or foam sclerotherapy are necessary to decide which method is the best for which patient.