Varicose Veins – Keyhole Procedures

This page will provide you with information about varicose vein keyhole procedures. For further details, please speak to your consultant.

VNUS (radiofrequency) closure of varicose veins

This is one of the most popular keyhole vein procedures and can be performed under local anaesthetic – however, some patients do prefer to be under sedation whilst the procedure is performed.

General anaesthetic is also used if the veins in question are particularly large or extensive.

What will happen during the procedure?

The procedure begins with a 2mm wide tube being inserted into the vein needing closure. This is done using ultrasound control. The vein is then internally heated using high-frequency ultrasound waves.

With this procedure the vein is destroyed without the need to remove. With only a small incision needing to be made, the patient can return home that same day.

Some patients may experience a little discomfort and some stiffness following the procedure, but most can continue with their normal activities as soon as the procedure is completed. In up to 95% of cases the veins remain sealed in the long-term.

In cases where patients receive radiofrequency treatment in one leg and stripping in the other, most preferred the outcome of the leg treated with the former.

Laser ablation procedure for keyhole treatment of varicose veins (EVLA)

It is not uncommon for lasers to be used in various medical procedures, including cancer treatment and corneal reshaping. They are also used for EVLA (endovenous ablation) procedures. This is where a laser fibre is inserted into the saphenous vein, which then heats the blood to a very high temperature. A steam bubble is then created which destroys and closes off the vein.

VNUS treatment is usually less painful and results in less bruising post-operation, so is generally the preferred method of varicose vein treatment.

Patients opting for EVLA should educate themselves on post-operative instructions and complications.

Bioadhesive glue (Venaseal)

Bioadhesive glue under ultrasound control has been found to effectively seal an abnormal vein within 30 days. Whilst tissue glues have been used before to close small cuts or lacerations, the application of glue for varicose veins has only recently been discovered.

This is possibly the most patient-friendly of the above procedures as it requires no local anaesthetic and patients are not required to wear stockings afterwards. As this is a relatively new procedure, however, how long the results last are unknown.

Small varicose vein excision

If painful and bulging varicose veins are an issue, “avulsions” performed alongside or instead of the keyhole procedures mentioned may be advised. These are small, 2-3mm incisions made over the vein in order to remove them. These incisions are sealed with surgical tape, to be removed no sooner than two days after the procedure. After this, it is often common to experience bruising and a bumpy feeling in the area; these side-effects usually diminish within 4-6 weeks.

The incisions made in this operation can leave scarring which may be worse if you have pale skin or are prone to scars. The appearance of these can be unpredictable.

Risks and complications

Any risks or complications will be discussed in advance of your treatment with your expert consultant.


EIDO Healthcare Limited – The operation and treatment information on this website is produced using information from EIDO Healthcare Ltd and is licensed by Aspen Healthcare.

The information should not replace advice that your relevant health professional would give you.

Varicose Veins – Keyhole Procedures Consultants