Which vein treatment has the highest success rate?

EVLA, RFA, and VenaSeal all achieve 94–98% vein closure rates at one year — comparable to surgical stripping but with far less pain and recovery time.

Is EVLA the same as laser treatment?

Yes — EVLA stands for Endovenous Laser Ablation. A thin laser fibre is inserted into the vein under ultrasound guidance and delivers controlled heat to seal it from the inside.

Can I have sclerotherapy for large varicose veins?

Foam sclerotherapy under ultrasound guidance can treat medium-sized varicose tributaries, but for large truncal veins (GSV/SSV) with significant reflux, thermal ablation (EVLA/RFA) or VenaSeal is more appropriate and durable.

How do I know which treatment is covered by kupat holim?

EVLA at Shamir Medical Center is the main procedure eligible for tofes 17 kupat holim funding. A duplex ultrasound diagnosing venous insufficiency is needed to initiate the referral process.

What if I have both varicose veins and spider veins?

Treatment usually proceeds in stages: first address the underlying truncal reflux (EVLA/RFA/VenaSeal), then treat residual tributaries and spider veins with sclerotherapy 6–8 weeks later.

Which Varicose Vein Treatment Is Right for Me?

Not all varicose vein treatments are the same — and the right choice depends on your specific anatomy, severity, symptoms, and insurance coverage. This guide helps you understand your options and what to expect at your consultation. Also see: recovery timelines for each procedure.

Step 1 — What Are Your Symptoms?

If you have…	Most likely diagnosis	Likely treatment
Only fine red/blue spider veins	Telangiectasias (C1)	Cosmetic sclerotherapy
Small (<5mm) bulging veins, mild symptoms	Varicose veins without truncal reflux (C2)	Sclerotherapy or VenaSeal
Larger (5–15mm) twisted veins, aching, heaviness	Truncal venous insufficiency (C2–C3)	EVLA, RFA, or VenaSeal of GSV/SSV
Leg swelling, skin changes, discolouration	Advanced venous insufficiency (C3–C4)	EVLA (tofes 17 eligible) + sclerotherapy
Healed or active venous ulcer	C5–C6 severe venous disease	Urgent evaluation — EVLA + wound care

Step 2 — Insurance or Private?

Kupat holim eligible (tofes 17): EVLA at Shamir Medical Center for clinical venous insufficiency — Clalit, Maccabi, Meuhedet, Leumit
Private: All cosmetic treatments, VenaSeal, RFA, sclerotherapy for spider veins
May be covered (private insurance): VenaSeal, medically indicated sclerotherapy

Step 3 — Recovery Preference

Procedure	Time off work	Compression required	Return to sport
Cosmetic sclerotherapy	Same day	1–2 weeks	1 week
VenaSeal	Same day	1 week (recommended)	1 week
EVLA / RFA	1–2 days	2 weeks	2 weeks

Full Treatment Comparison Table

Feature	EVLA	RFA	VenaSeal	Sclerotherapy
Mechanism	Laser heat	RF heat	Medical adhesive	Chemical irritant
Best for	GSV/SSV insufficiency	GSV/SSV insufficiency	Large/tortuous veins	Spider + tributaries
Anaesthesia	Tumescent local	Tumescent local	Minimal local	None / topical
Closure rate (1yr)	94–97%	95–98%	94–97%	70–90% (multi-session)
Tofes 17 eligible	✅ Yes (Shamir)	❌ Private only	❌ Private only	Depends on indication
Approximate cost	Via kupat holim	At consultation	₪15,000	₪1,500/session

Book a consultation for your personalised treatment plan

Schedule Now

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

References

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.
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.
European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease. Eur J Vasc Endovasc Surg, 2022.