Heat, Glue, or Foam? Understanding Your Modern Varicose Vein Treatment Options

Beyond "One Size Fits All" in Vein Care

If you've been diagnosed with varicose veins or Chronic Venous Insufficiency (CVI), you might be wondering what comes next. In the past, treatment options were limited and often involved invasive surgery. Today, however, the field of vein care has been revolutionized by technology. The modern approach is not "one size fits all"; it's about leveraging a sophisticated toolkit of minimally invasive procedures to create a treatment plan that is perfectly tailored to your unique anatomy and needs.

But with options labeled with terms like "thermal ablation," "medical adhesives," and "foam," it can be difficult for patients to understand the differences. This guide will break down the leading modern varicose vein treatments so you can have an informed conversation with your specialist about the best path forward for you.

The Foundational Goal: Closing the "Source" Vein

Before diving into the methods, it's important to understand the goal. Most symptomatic varicose veins are caused by a larger, deeper superficial vein (most often the great saphenous vein, or GSV) that has failing valves. This unhealthy "source" vein allows blood to flow backward and pool, creating the pressure that forms the bulging veins you can see.

Therefore, the primary goal of most modern treatments is to permanently close this faulty source vein. Once it's sealed off, the blood naturally reroutes to the many other healthy veins in the leg, the pressure is relieved, and the symptoms resolve. The key difference between procedures is how they achieve this closure.

Method 1: Thermal Ablation (Heat) - The Proven Gold Standard

Endovenous Thermal Ablation is the most established and widely performed minimally invasive treatment for varicose veins. It uses controlled heat to seal the vein shut from the inside.

• How it works: Using ultrasound guidance, a thin catheter is inserted into the diseased vein through a tiny entry point. This catheter has a specialized tip that delivers either Radiofrequency (RF) energy or Laser (EVLA) energy to the vein wall. This energy gently heats the collagen in the wall, causing it to shrink and collapse, permanently closing the vein.

  
  

• Pros: This method has decades of clinical data proving its long-term effectiveness and safety. It is considered the gold standard by most insurance companies for treating CVI.

• Cons: It requires the use of tumescent anesthesia—a series of numbing injections along the length of the vein—to ensure patient comfort and protect surrounding tissues from the heat.

Method 2: Medical Adhesives (Glue) - The Innovative Newcomer

The newest major advancement in vein care involves using a medical-grade "superglue" to seal the vein.

• How it works: Known by the brand name VenaSeal™, this procedure also uses a catheter to access the faulty vein. Through the catheter, a physician injects small drops of a proprietary cyanoacrylate adhesive. The specialist then applies external pressure, and the vein walls are glued shut.

• Pros: The primary advantage is that it does not require heat, and therefore does not require multiple injections of tumescent anesthesia. This can mean a more comfortable procedure and often less requirement for post-procedure compression stockings.

• Cons: As a newer technology, it has less long-term data than thermal ablation and may not be the ideal choice for all types or sizes of veins.

Method 3: Chemical Ablation (Foam) - The Versatile Tool

While liquid sclerotherapy is used for spider veins, a special "foamed" version of the same medication is a powerful tool for larger, more complex veins.

• How it works: Known as Ultrasound-Guided Foam Sclerotherapy, a specialist injects a medicated foam directly into the diseased vein while watching on an ultrasound screen. The foam displaces the blood and irritates the vein wall, causing it to spasm and seal shut.

• Pros: This method is extremely versatile. It is perfect for treating veins that are very twisted and difficult for a catheter to pass through, as well as for treating any large branch varicose veins that remain after a primary source vein has been closed.

Conclusion: The Best Treatment is a Personalized Treatment

So, which option is best? The answer is: the one that is best for you. An expert vein specialist will choose the right tool from their toolkit based on a detailed ultrasound map of your legs. They will consider the size, depth, and straightness of your veins to create a personalized plan. In many cases, a combination of techniques is used to achieve the best possible outcome.

The number of options can feel overwhelming, but our specialists can simplify it for you. Schedule a consultation at Sinai Vein and Wound Care to receive a comprehensive evaluation and discover which state-of-the-art treatment is perfect for your specific needs.