Endovenous thermal ablation therapy (EVLT) and radiofrequency ablation (RFA) are image-guided, minimally invasive procedures that are used to treat venous reflux disease. The procedures are used to ease symptoms from dysfunctional, inflamed, discolored, or ulcerated veins, but also can be used for cosmetic purposes.

Both procedures heat the inside of the vein to seal it off, and the body automatically direct the blood to healthier veins. The difference in the procedures is the energy source; EVLT uses laser energy and RFA uses radiofrequency energy.

The EVLT and RFA procedures are performed on an outpatient basis using local anesthetic and pain medication. The procedures take between one and two hours to complete with minimal discomfort.

Your interventional radiologist will determine which procedure is best for your condition.

It is important to know:

  • These procedures do not provide instant, but gradual results and may take between two to three months for veins to fully improve.
  • These treatments are not for spider veins, but sclerotherapy can be used in conjunction with EVLT.
  • After the procedure, patients may still have varicose veins; however, they will be less noticeable.

Diagnosis and treatment

First patient undergo a physical exam, provide their medical history, and have a leg evaluation. Next, an ultrasound may be ordered to rule out underlying issues and will determine if you are a candidate for the procedure. The last step is discussing the treatment with the interventional radiologist.

For endovenous laser treatment the procedure will take between one to two hours to complete. Patients lie on a special treatment table and wear protective eyewear to shield their eyes from the laser. After a local anesthetic, the catheter and laser are inserted into the vein. When it reaches the optimal location, the laser is activated, and heat applied to the vein wall, causing the vein to close.

For radiofrequency ablation, the procedure takes about two hours to complete. After a local anesthetic, the catheter is guided to the precise location using ultrasound, and the radio frequency generated heat is delivered to the vein wall, causing the vein to shrink and seal.

Following procedure, patients need to wear compression hose.


Patients can usually return to work within 24 to 48 hours. Normal daily activities can be resumed in about a week to ten days.

After the procedure, a follow-up appointment will be scheduled.

NOTE: These treatments may be covered by insurance if they are deemed medically necessary procedures by your insurance company.