Lasers (EVLT) and Catheters (VNUS closure)

Several new techniques to treat large varicose veins have been developed over the last decade. Using lasers (EVLT) and catheters (VNUS closure) has been introduced as a way to burn the saphenous vein in the inner thigh with the assumption that this vein is the main source of varicose veins in the leg.

In both techniques, a fiber is passed through the long Saphenous Vein in the leg and moved all the way up to the groin. The catheter temperature is then raised high enough to “burn” the Saphenous vein in the thigh.

About 60% of our patients have had these procedures in the recent past (sometimes twice) only to find that their varicose veins recur shortly thereafter.

We do not recommend lasers (EVLT) and catheters (VNUS closure) as the best ways to treat varicose veins and spider veins for several reasons:

  1. They fail to close the top leak in the groin which may reopen the saphenous vein again.
  2. They fail to close a second system next to the Saphenous vein that many patients have (called accessory system).
  3. In some patients, the cause of varicose veins lies behind the knee or comes from pelvic veins. In a small number of patients, the high heat causes damage to the deeper veins and results in the formation of clots in the deeper veins with potential risks.
  4. In many studies, around 10% of these veins re-open after several few months.

We consider all these issues major drawbacks to these procedures. Like every other procedure, the solution must be addressed once.


In the outdated and old fashioned stripping method, varicose veins are taken out through large, unsightly incisions leaving permanent scars. This form of varicose vein surgery is no longer suitable, although it is still being performed.

This invasive procedure could lead to patients in the hospital or in bed away from their usual activity for several weeks, depending on the severity of the case.

These procedures fail to address the real problem.

Varicose veins and spider veins are caused by faulty values within them, allowing the downward flow of blood in the veins. This wrong direction gradually enlarges the veins and changes them into larger and twisted varicose veins. These veins will not disappear until all of the sources are treated.

The Veno-Merse® Technique

Our patented technique, the Veno-Merse® Technique, addresses this issue—the source of the problem.

Only then, after all the leaks and larger feeding veins are closed, lasers are effective tools to treat the smaller spider veins. Doing laser work and Sclerotherapy prior to this step would be ineffective and results in early recurrence of the varicose veins and spider veins.

With the Veno-Merse® Technique, exercise is encouraged as it helps to reduce the swelling from varicose veins and also helps to close the veins faster.