EVLA is an established gold standard technique for the treatment of varicose veins and has replaced traditional surgical techniques in the treatment of varicose veins in most cases. The abnormal vein is heated by a laser. A wire with a laser tip is introduced into the vein via a catheter using a minimally invasive keyhole approach. The laser tip is advanced to the highest point to be treated or up to 2cm from any junction with the deep veins. The laser is then activated, which destroys the internal walls of the vein. The body then absorbs the dead tissue, getting rid of the varicose vein. the procedure is carried out under local anaesthetic, using a technique called tumescent anaesthesia. where a large volume of dilute anaesthetic solution is injected along the leg through small needle pricks. It has a 98% success rate and maintains that rate for ten years.

This is the most recent advancement in the management of varicose veins. This technique uses superglue to stick the vein walls together. In due course, the glue initiates a scarring process and the veins shrivel and get destroyed.
Unlike laser and radiofrequency, this technique does not require numerous injections. One single injection at the point of entry is all that is required. Once complete there is no need for compression stockings. Pain and discomfort are reported to be less after glue usage.
The disadvantage is that the method has been approved for clinical use only recently. Hence there is not much evidence of long term results ( 10 years and beyond). Endothermal ablation has evidence for a 97% occlusion rate at 10 years. The glue is applied 5cm away from the junction unlike laser/Radiofrequency (2cm) from the junction. Therefore the risk of recurrence is theoretically high for glue.
If you choose to have glue to treat your veins, you agree to be part of clinical governance meaning you will agree to be seen annually for 5 years to check the veins by ultrasound and leg clinically.