A comparative study of endovenous laser ablation and radiofrequency ablation in the management of varicose veins

Background: Endovenous thermal ablation techniques, including Endovenous Laser Ablation (EVLA) and Radiofrequency Ablation (RFA), have largely replaced conventional surgery for varicose veins. This study compares the short-term efficacy and complication profile of EVLA and RFA. Methods: A retrospective analysis of 127 patients with symptomatic varicose veins treated between January 2019 and March 2024 was conducted. Patients were grouped into RFA (n = 49) and EVLA (n = 78) cohorts. Outcome measures included procedure time, pain scores (6 hrs, 1 day, 10 days), time to return to activity, and complications. Results: The mean procedure duration was 1.31 ± 0.42 hours in the RFA group and 1.23 ± 0.41 hours in the EVLA group (p = 0.321). Pain scores at 6 hours post-procedure were higher in the RFA group (3.65 ± 0.78) compared to the EVLA group (3.38 ± 0.69), though the difference was not statistically significant (p = 0.051). Patients in the EVLA group returned to normal activity significantly earlier (2.26 ± 0.52 days) than those in the RFA group (2.69 ± 0.55 days), with a highly significant difference (p < 0.001). Minor complications were comparable in both groups; however, two cases of tip breakage occurred in the EVLA group. Conclusion: Both RFA and EVLA are effective and safe, but EVLA offers quicker recovery. Long-term comparative studies are warranted.