A patient with chronic venous insufficiency is treated with a procedure. What is the most effective intervention?

• A. Endovenous laser ablation
• B. Sclerotherapy
• C. Surgical vein stripping
• D. Venous reconstruction

Answer: (A)

Endovenous laser ablation is the best option because it directly targets and closes the refluxing superficial vein trunk (usually the great or small saphenous vein) from inside the vein using energy delivered by a catheter. This causes the vein wall to collapse and fibrose, effectively eliminating the abnormal reflux source. The result is durable closure, rapid symptom relief, and a quick recovery with fewer complications compared to open surgery.

Sclerotherapy can treat smaller varicose veins and tributaries, but it’s less reliable for large incompetent trunks. Surgical vein stripping is more invasive, with longer recovery and higher risks, and is increasingly less favored for trunk reflux. Venous reconstruction isn’t a typical first-line approach for chronic venous insufficiency and is reserved for complex deep venous problems.