EVLT vs VenaSeal (Medical Glue) for Varicose Veins

What is VenaSeal?

VenaSeal is a brand of medical adhesive system used to close refluxing saphenous veins. Under ultrasound guidance, a thin catheter is placed in the vein. Small amounts of a cyanoacrylate-based glue are delivered at intervals while the doctor presses on the leg to squeeze the vein walls together. The glue bonds the walls, blood stops flowing through that segment, and over time the body walls off the glue with scar tissue. It is often called "glue" or "cyanoacrylate closure."

What is EVLT?

Endovenous laser treatment uses a laser fiber about as thin as a hair, introduced through a needle puncture. Dilute local anesthetic is injected around the vein along its length (tumescent anesthesia) to numb it, compress it onto the fiber and protect surrounding tissue. As the fiber is withdrawn, laser energy heats and seals the wall. The closed vein is absorbed over the following months. At LEDAS, EVLT uses a 1940nm diode laser.

How do EVLT and VenaSeal compare?

Anesthesia and comfort during the procedure

The main practical advantage claimed for glue is that it does not need tumescent anesthesia, so there are fewer needle sticks along the leg. EVLT requires a series of anesthetic injections, which most people describe as the most noticeable part of the procedure; once they are done, the laser itself is usually comfortable.

Heat and nerves

Because glue is non-thermal, there is no heat to irritate nearby skin nerves. With EVLT, the tumescent fluid layer and water-targeted wavelengths like 1940nm are designed to limit heat spread, but temporary numbness can still occur, particularly below the knee.

Material left behind

After EVLT, nothing foreign remains: the vein is sealed by the body's own tissue reaction and absorbed. After glue, the adhesive remains in the leg and is gradually encapsulated. Some patients develop a local inflammatory reaction over the treated vein, sometimes described as phlebitis-like or allergic-type, which is usually manageable but can be prolonged. People with known sensitivity to acrylates are generally not suitable for glue.

Compression and recovery

Compression stockings are typically advised after EVLT; after glue, some protocols use less or no compression. With both, walking is encouraged and same-day discharge is the norm.

Branches still need treatment

Neither method treats twisted branch veins or perforators well. These are usually handled with foam sclerotherapy or phlebectomy. At LEDAS, they are treated with duplex-guided sclerotherapy .

Why does LEDAS use EVLT rather than glue?

LEDAS has built its approach around EVLT combined with ultrasound-guided sclerotherapy. Laser closure leaves no implanted material, and the clinic uses a 1940nm wavelength chosen to concentrate heat in the vein wall. Pairing it with real-time ultrasound on Philips EPIQ Elite systems allows precise fiber positioning and confirmation of closure. LEDAS does not offer VenaSeal or other adhesive treatments.

How should I decide?

Both methods can close a suitable saphenous trunk effectively. Ask any clinic you are considering about their diagnosis process, which veins will be treated, how branches are handled, and what follow-up they provide. A good result depends more on complete diagnosis and planning than on the closure method alone. See also EVLT vs RFA and how to choose a vein clinic .

EVLT vs VenaSeal side by side

EVLT vs VenaSeal – frequently asked questions