Concierge vascular · London
Endovenous laser therapy for varicose veins, by a consultant vascular surgeon.
NICE CG168 first-line: endothermal ablation (laser or RFA) closes the refluxing vein through a pinhole, under local and tumescent anaesthetic — you walk out the same day. VenaSeal glue and MOCA are on the table when they fit your anatomy better.
Why patients choose us
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A consultant vascular surgeon, in theatre
Not a treatment room and not a training list. A named vascular surgeon or interventional radiologist, a duplex ultrasound, and the right modality for your vein anatomy.
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Laser, RFA, glue or MOCA — on the table
NICE recommends endothermal ablation first, but if your vein sits close to the saphenous nerve or below the knee, non-thermal options (VenaSeal glue, MOCA) may be safer. We say so up front.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private varicose vein treatment costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three modalities.
In short
Endovenous laser in our network: £2,000–£3,500 per leg, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Endovenous laser ablation (EVLA/EVLT), one leg | £2,000–£3,500 | 60–90 min | Same visit |
| Radiofrequency ablation (RFA — ClosureFast) | £2,200–£3,800 | 60–90 min | Same visit |
| VenaSeal (cyanoacrylate glue) | £2,800–£4,000 | 45–60 min | Same visit |
| MOCA (Clarivein, mechanochemical) | £2,500–£3,800 | 45–60 min | Same visit |
| Ultrasound-guided foam sclerotherapy | £800–£1,600 | 30–45 min | Same visit |
| Duplex ultrasound mapping (venous) | £300–£500 | 30–45 min | Same visit |
| Consultation only | £200–£400 | 30 min | Same visit |
Prices vary by clinic, by which operator does the case, by the modality chosen, and by whether both legs or bilateral phlebectomy is added on the day. We come back with a firm quote within one working day.
The problem
The right operator, the right modality, evidence over habit.
Varicose vein treatment is a market where the modality on offer often depends on what the clinic owns — not what suits your anatomy. Every good pathway starts with a duplex map and ends with a considered choice between laser, RFA, glue and MOCA.
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Not sure it needs treating?
Some veins are purely cosmetic; others cause real chronic disease. A duplex map and a proper consultation tells you which is which.
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Worried about the recovery?
Local and tumescent anaesthetic, walk in an hour, drive the next day, office work in 48 hours. Gym at two weeks.
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Want it done properly?
A named consultant vascular surgeon or interventional radiologist, a duplex map, and a surveillance duplex afterwards.
The journey
From enquiry to surveillance duplex — what happens, in order.
One clinician from first message to review — including the surveillance duplex.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A couple of hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Aching, swelling, itching, skin changes, bleeding, ulcers, or purely cosmetic concern.
- 02
Before
We come back with a recommendation
Within one working day: the right modality (laser, RFA, glue or MOCA), the right operator, an indicative price. If reflux is not the cause, we say so.
- 03
Before
Duplex ultrasound mapping
A vascular scientist maps every refluxing vein — great, small and accessory saphenous — so the treatment plan is built on evidence, not eyeballing.
- 04
On the day
Arrival at the clinic
Arrival, consent and a chat with the surgeon. Local anaesthetic and tumescent Klein solution — no general anaesthetic needed.
- 05
On the day
The procedure itself
45 to 90 minutes in a proper theatre. Ultrasound-guided access, laser or RFA fibre withdrawal at the correct energy, phlebectomy or foam for tributaries.
- 06
On the day
Home the same day
A compression stocking, a short walk in the corridor, and home within a couple of hours. You drive the next day.
- 07
After
Recovery and duplex review
Bruising and tightness for two to four weeks. A surveillance duplex at one to four weeks checks the vein has closed and rules out endothermal heat-induced thrombosis.
Typical end-to-end: 2–3 weeks from enquiry to procedure. Surveillance duplex: 1–4 weeks after.
When it helps
When endovenous ablation is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Aching, heavy legs
A dragging, tired ache that gets worse as the day goes on and eases when the legs are up — the classic pattern of venous reflux.
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Visible varicose veins (CEAP C2)
Bulging, ropey veins above the surface. If symptomatic, NICE CG168 supports referral for endothermal ablation.
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Skin changes or eczema (C4)
Brown pigmentation, thickening or itchy eczema around the ankle — a sign chronic venous hypertension is affecting the skin.
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Bleeding varicose vein
A varicose vein that has bled through the skin — an indication for prompt treatment, not a wait-and-see.
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Superficial thrombophlebitis
A red, tender, corded vein — treat the acute episode, then close the underlying refluxing trunk to stop it recurring.
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Healed or active venous ulcer (C5/C6)
Ulceration near the ankle. The EVRA trial showed early ablation heals ulcers faster than compression alone.
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After pregnancy
Veins that appeared in pregnancy and did not settle after six months. Treat once the family is complete.
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Red flag: hot, swollen calf
A hot, swollen, tender calf can be a deep vein thrombosis — same-day A&E or urgent GP, not a clinic booking.
Modality options
Laser is first-line — but not the only option.
What each modality actually involves — and which fits which anatomy, per NICE CG168.
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Endovenous laser (EVLA/EVLT)
1470 or 1940nm laser fibre — modern wavelengths mean less bruising than the older 810/980nm. First-line under NICE CG168 for truncal reflux.
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Radiofrequency ablation (RFA)
ClosureFast catheter delivers heat in 7cm segments. Equivalent to laser at five years (EVRA trial). Some patients report less immediate bruising.
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VenaSeal (cyanoacrylate glue)
Non-thermal — a medical glue seals the vein. No tumescent anaesthetic, no compression stocking, no nerve-injury risk. Ideal below the knee.
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MOCA (Clarivein)
A rotating wire plus sclerosant. Non-thermal, so safer near the saphenous nerve. Good for small saphenous vein and below-knee segments.
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Foam sclerotherapy (UGFS)
Second-line under NICE if endothermal ablation is unsuitable. Also used as an adjunct for residual reticular veins and tributaries.
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Ambulatory phlebectomy
Tiny stab incisions remove the bulging surface tributaries at the same visit. Combined with truncal ablation for a one-stop result.
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Open surgery (stripping)
Third-line only. Rarely done now — reserved for anatomy that endothermal or non-thermal options cannot reach.
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Consultation only
An honest discussion of whether treatment is needed, and which modality fits your anatomy — no obligation.
Our vetted London network
A small panel of vein specialists, we picked them.
Consultant vascular surgeons and interventional radiologists across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your duplex map.
Selection criteria
How we choose every vein specialist in our network.
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Consultant vascular surgeons or interventional radiologists, not trainees
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Duplex ultrasound mapping performed before every procedure
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Full menu on offer — laser, RFA, VenaSeal, MOCA and foam
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Surveillance duplex arranged post-procedure to rule out EHIT
Safety and recovery
What to expect afterwards — honestly.
Endovenous ablation is a common, safe day-case procedure. The things worth planning are your compression stocking, the walking regime, and knowing what is normal after.
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Local and tumescent — no general anaesthetic
Klein tumescent solution numbs the vein and protects surrounding tissues. You are awake, comfortable, and home the same day.
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Bruising and tightness for two to four weeks
A cord-like feeling along the treated vein is normal and settles. Simple painkillers and walking help.
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Compression stocking for 7–14 days
Worn day and night for the first week, then daytime only. VenaSeal is the exception — no stocking required.
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Walk immediately, drive the next day
Walking twice an hour on day one reduces DVT risk. Back to office work in 24–48 hours; gym at two weeks.
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DVT risk is low but real (0.5–2%)
The reason we insist on early mobilisation and a surveillance duplex — small clots can extend into the deep system if missed.
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Saphenous nerve paraesthesia
Numb patches near the shin or ankle, especially with below-knee treatment. Usually settles over weeks. Non-thermal options avoid this.
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Endothermal heat-induced thrombosis (EHIT)
A clot at the junction with the deep vein. Screened for by duplex at 1–4 weeks; treated with anticoagulation if grade 2 or above.
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Hyperpigmentation and matting
Brown staining or fine red vessels can appear along treated segments. Usually fades over months; occasionally needs sclerotherapy touch-up.
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Red flags
A hot, swollen calf, spreading redness or shortness of breath after the procedure are not normal — call the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever modality was used, the note the specialist sends you keeps to the same shape.
A quiet reminder
Vascular language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Vein treated and modality used
Which vein was treated — great, small or accessory saphenous — and whether laser, RFA, glue or MOCA was used.
- 02 Technique
Access, energy delivered, adjuncts
Access point, fibre length treated, energy density (LEED in J/cm), and any phlebectomy or foam sclerotherapy done at the same visit.
- 03 Findings
Closure confirmed on table, junction status
Immediate closure on ultrasound, distance from the saphenofemoral or saphenopopliteal junction, and any incidental findings.
- 04 Impression
Compression, walking, review timing
Read this first: stocking regime, when to walk, drive and exercise, and the date of your surveillance duplex.
Recognised by major UK insurers
Cover for varicose vein treatment varies by insurer and indication — usually funded when symptomatic (aching, skin changes, bleeding, ulcer) per NICE CG168, self-pay for cosmetic cases. We confirm cover before booking.
Frequently asked
Everything we get asked about endovenous laser therapy.
Quick answers on modality choice, cost, alternatives, and how much time off work you actually need.
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What is endovenous laser therapy (EVLA/EVLT)?
A minimally invasive treatment for varicose veins. A thin laser fibre is passed inside the refluxing vein under ultrasound guidance, then withdrawn slowly to seal the vein from the inside using heat. It replaces the old operation of stripping the vein out.
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Is laser better than radiofrequency ablation (RFA)?
Neither is medically superior. The EVRA trial and long-term data show equivalent closure rates at five years. Laser at newer 1470/1940nm wavelengths causes less bruising than older lasers. RFA (ClosureFast) is a smooth, segment-by-segment treatment. The right choice depends on your anatomy and the operator’s experience.
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How much does endovenous laser therapy cost privately in the UK?
Roughly £2,000–£3,500 per leg for laser, £2,200–£3,800 for RFA, £2,800–£4,000 for VenaSeal glue, and £2,500–£3,800 for MOCA. Foam sclerotherapy alone is £800–£1,600. We confirm a firm figure within one working day.
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Does the NHS cover varicose vein treatment?
The NHS follows NICE CG168 — it will treat symptomatic varicose veins (bleeding, phlebitis, ulcer, skin changes, or significant symptoms). Purely cosmetic treatment is not funded. Waiting lists vary from months to over a year, which is why many patients choose private.
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What are the alternatives to laser?
Under NICE, endothermal ablation (laser or RFA) is first-line, ultrasound-guided foam sclerotherapy second-line, and open surgery third-line. Non-thermal options — VenaSeal cyanoacrylate glue and MOCA (Clarivein) — are useful when the vein sits close to the saphenous nerve, particularly below the knee.
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How long does recovery take?
You walk within an hour of the procedure, drive the next day, and return to office work within 24–48 hours. Bruising and a tight, cord-like feeling settle over two to four weeks. Gym and heavy exercise wait a fortnight.
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Do the veins come back?
Closure rates are around 95% at 12 months and remain high at five years. Some patients develop new varicose veins in different segments over time — venous disease is a chronic condition, not a one-off event. Surveillance duplex catches recurrence early.
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What are the risks?
Bruising and tightness are near-universal. Deep vein thrombosis occurs in about 0.5–2% of cases; saphenous nerve paraesthesia can happen with below-knee treatment; endothermal heat-induced thrombosis (EHIT) is screened for on surveillance duplex; hyperpigmentation and matting can occur; cyanoacrylate allergy is rare but described with VenaSeal.
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When should I see a doctor urgently?
A hot, swollen, painful calf can be a deep vein thrombosis — same-day A&E. Sudden shortness of breath after any leg procedure needs 999. A varicose vein that has bled through the skin needs prompt assessment. Spreading redness or fever after treatment are not normal.
Related tests
Looking for something else?
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Duplex ultrasound
The scan that maps venous reflux before treatment.
Learn more -
Deep vein thrombosis
When leg swelling needs urgent assessment, not a clinic.
Learn more -
Vascular consultation
A consultant vascular opinion before you commit to anything.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more