If you’re dealing with varicose veins or persistent symptoms such as heaviness, aching, and swelling, endovenous laser ablation (EVLA) or radiofrequency ablation (RFA) may be the next step in regaining your comfort and mobility. But how do the two thermal ablation treatments compare, and which is right for you? That’s what we’re tackling in today’s blog.
At McWilliams Vein Center, located in Wheaton, IL, expert vascular specialist Dr. Sean McWilliams has decades of experience in minimally invasive office-based treatments to close problem veins. EVLA and RFA are two of the leading procedures we offer for varicose veins. While they’re similar, there are some key differences to be aware of.
What is EVLA?
EVLA utilizes a thin laser fiber inserted into the target vein under ultrasound guidance. After numbing fluid (tumescent anesthesia) is introduced around the vein, the laser delivers controlled heat along the vein’s inner wall.
This heat causes the vein to collapse and seal shut. Dr. McWilliams can tailor EVLA with different laser wavelengths and fibers. It’s effective for both the great and small saphenous veins, as well as many accessory veins.
What is RFA?
RFA also treats from the inside, but instead of laser light, it uses radiofrequency energy delivered through a specialized catheter. With tumescent anesthesia and ultrasound guidance, the catheter heats segment by segment as it’s withdrawn, closing the vein.
The technique is precise and consistent, and like EVLA, it’s commonly used for refluxing saphenous veins.
What’s Similar About EVLA and RFA?
Both are done through a tiny skin puncture, take about 30–60 minutes, and use local anesthesia so you’re comfortable. You can walk immediately afterward and resume most normal activities within a day.
Common short-term effects include mild tenderness, bruising, or a “cord-like” feeling as the vein seals. Walking and wearing graduated compression stockings for a short period can help with recovery. Many patients will still need follow-up treatment for tributary veins, such as foam sclerotherapy or microphlebectomy, to fully address bulging surface veins.
Key Differences to Consider
• Energy source: EVLA uses laser; RFA uses radiofrequency heat.
• Sensation and bruising: Some patients report slightly less post-procedure soreness or bruising with RFA; others feel they recover equally with either.
• Vein anatomy and fiber/catheter choice: Tortuosity, depth, and diameter can make one approach preferable for a specific vein. Your ultrasound map drives that choice.
With both types of thermal ablation, expertise makes a huge difference in outcomes. At McWilliams Vein Center, you benefit from the unique specialized skills of Dr. McWilliams, who is an expert in both thermal techniques.
Which is Best for Your Veins?
Both EVLA and RFA are proven, durable treatments with high closure rates and symptom relief. The “best” option depends on your ultrasound findings, skin and soft-tissue characteristics, prior procedures, pain tolerance, schedule, and goals.
Schedule Thermal Ablation in Wheaton, IL
Call McWilliams Vein Center at 630-474-2600 in Wheaton, IL, to book your appointment and learn more about thermal ablation.
