What is the difference between RFA and EVLA, which one is better?

It’s important to distinguish between varicose veins and spider veins when choosing between laser therapy, sclerotherapy, and vein surgery. With two board certified vein specialists, our center uses a combination of visual examination, functional flow measurements, ultrasound, transillumination, and infrared light to map out vein networks prior to therapy. Lasers can be used to treat deep varicose vein insufficiency, vein perforators, and varicose veins. Sclerotherapy is ideal for spider veins and reticular veins. Whereas surgery is reserved for severely incompetent varicose vein segments.


Best,
Dr. Karamanoukian
Realself100 surgeon

Both procedures use thermal energy and are essentially equal in closure rates. RFA seems slightly better tolerated post procedure. Having had RFA done on one leg and EVLT on the other I did not feel a significant difference.

Both methods are effective in treatment of varicose veins but they use different energy modalities to achieve their end result. Your surgeon can further discuss the pros and cons of each method during your consultation. 

Both RFA and Laser use heat energy to close diseased veins.  Both have excellent long term success rates.  I have used both and typically prefer RFA.  There have been multiple studies showing less post-op pain and bruising with RFA compared to laser and personal experience has confirmed this.  Having said that, the post op pain with both is mild.  Also, the newer, longer wavelength lasers can approach the results seen with RF if done with radial tip laser fibers.  If you go to a provider using laser, I would recommend that you ask if they are using a 1470 laser with a radial tip, or just have an RFA as those tend to hurt less.  Laser does have advantage over RFA in terms of versatility as it can treat both saphenous veins and perforators at the same setting, with the same fiber, so in those cases a laser may be a better option.  Good luck

RFA is radio frequency ablation and EVLA is endovenous laser ablation.  Both do the same thing and that is to close the leaking valves. One uses radio frequency and one uses laser.  What procedure is used usually depends on the experience of the treating physician.  I prefer laser.

As noted, both are methods to treat refluxing varicose veins.  Both procedures are done in very similar fashions.  RFA is radiofrequency ablation, EVLT is endovenous Laser Therapy.  Both work equally and have similar long term success rates.  The only difference I have found is EVLT tends to cause a little more discomfort in the first 1-2 weeks. Good luck to you,Dr. Powell