Is VenaSeal better than sclerotherapy?

VenaSeal achieves higher single-session closure rates for large truncal veins with less bruising and faster recovery. For spider veins and small tributaries, sclerotherapy is the standard and cost-effective choice.

How many sclerotherapy sessions do I need?

Most cosmetic spider vein clearance requires 2–5 sessions spaced 4–6 weeks apart. Foam sclerotherapy for larger veins may achieve good results in 1–3 sessions.

VenaSeal requires only one skin puncture and no tumescent anaesthesia. Most patients report minimal discomfort during the procedure.

Can I have VenaSeal on both legs at once?

Yes — bilateral VenaSeal is commonly performed in a single session, which is an advantage over EVLA/RFA which involves more extensive tumescent anaesthesia.

What happens to the glue after VenaSeal?

The cyanoacrylate adhesive remains permanently within the treated vein but becomes encapsulated by fibrous tissue. The vein gradually shrinks and becomes non-functional. The adhesive does not absorb but remains inert.

VenaSeal vs Sclerotherapy — Which Is Right for You?

Both VenaSeal and sclerotherapy close abnormal veins — but they work very differently and are suited to different types of veins. Here is an honest comparison.

How Each Works

VenaSeal is a medical-grade cyanoacrylate adhesive (similar to surgical superglue) injected directly into the vein through a tiny catheter under ultrasound guidance. The glue bonds the vein wall closed. The treated vein is absorbed by the body over several months. VenaSeal requires no tumescent local anaesthesia — only a single skin puncture.

Sclerotherapy uses a chemical irritant (usually polidocanol or sodium tetradecyl sulphate) injected into the vein through a fine needle. The chemical damages the vein endothelium, triggering an inflammatory response that seals and gradually absorbs the vein. It can be administered as a liquid (for fine spider veins) or as a foam (for larger tributaries, under ultrasound guidance).

Head-to-Head Comparison

Feature	VenaSeal	Sclerotherapy
Best vein size	>5mm (large truncal)	1–8mm (spider to medium)
Anaesthesia	Minimal (single puncture)	None
Number of sessions	Usually 1	2–5 for complete clearance
Compression post-procedure	1 week recommended	1–2 weeks mandatory
Closure rate (1 year)	94–97%	70–90% (varies by foam/liquid)
Post-procedure bruising	Minimal	Common (1–4 weeks)
Cost	₪15,000	₪1,500/session
Tofes 17 eligible	❌ No	Depends on indication

When VenaSeal Is the Better Choice

Large (8–20mm), tortuous GSV that is difficult to catheterise with laser
Patient cannot tolerate tumescent anaesthesia
Patient wants single-session treatment with minimal bruising
Active lifestyle — no heat means faster return to swimming, gym
Allergy to sclerosing agents

When Sclerotherapy Is the Better Choice

Spider veins or small superficial reticular veins (C1)
Residual tributary veins after EVLA/RFA/VenaSeal
Multiple small scattered veins requiring volume coverage
Cost is a primary consideration
Patient prefers needles over a catheter approach

Book a consultation for your personalised treatment plan

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Israel Vein Center — Dr. Shimon Aronhime, MD
📞 073-374-4040 | Lilienblum 17, Tel Aviv | Shamir Medical Center, Beer Yaakov

References

Morrison N, et al. Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). J Vasc Surg, 2015. PubMed
National Institute for Health and Care Excellence (NICE). Varicose veins: diagnosis and management (CG168) — recommends duplex ultrasound for diagnosis and endothermal ablation as first-line treatment.
Gloviczki P, et al. The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins. J Vasc Surg Venous Lymphat Disord, 2023–2024.