Which Spider Vein or Varicose Vein Treatment Is Recommended by the Top Doctors?

Our NYC Vein Experts Rank the Options.

Do you suffer from painful varicose veins, leg heaviness, cramping or swelling? We recommend an evaluation for an underlying disease called venous reflux. You don’t have to live with painful veins in your legs, thеrе are many safe, effective and non- ivasive treatment орtіоnѕ available, often covered by major insurances.

Fоrtunаtеlу, the Vein Center Of New York offers the latest technology, the treatments dо not rеquіrе a long or uncomfortable rесоvеrу and often patients are back to work the same day. Due to new, minimally-іnvаѕіvе and nearly-painless рrосеdurеѕ, mоѕt vein dіѕеаѕе саn nоw be trеаtеd оn аn outpatient bаѕіѕ.

Some of treatments offered at the Vein Center Of New York are the following:

Do you want to get rid of spider veins or varicose veins but don’t know the best way to do it?

Read on to see what the top NY doctors think about the various treatment options. You’ll learn the upsides and downsides of each method so you can make the right decision. You’ll also learn why it’s so important to choose the right vein doctor in New York City, and how to make that choice. Let our experts take the guesswork out of the process so you can skip straight to the results. 

If your parents described their vein treatment, you might be hesitant to follow in their footsteps. Vein treatment in prior generations was often unpleasant, particularly the surgical stripping method. But minimally invasive vein care has revolutionized the process in the last 30 years, outpacing all other fields in advancements. There are now a multitude of safer, gentler options, which is great news, but also confusing for patients. How do you know which one to choose? The answer depends on variables like your symptoms, overall health, and preferences. Our Manhattan vein doctors are here to help! Let’s look at each method up close to determine which one is best, and which doctor is best suited to perform it. 

First, it’s essential to understand why spider veins and varicose forms, since that’s a big piece of the treatment puzzle. Damaged veins at the surface of your skin might result from a problem below the surface, called venous insufficiency. This condition impairs the circulation of blood from the legs to the heart. Weak valves in leg veins allow blood to pool or regress, rather than progressing away from the feet. Pressure accumulates in the veins, prompting varicose vein or spider vein formation. If your doctor fails to identify this condition, the problem continues, and often becomes chronic. Choose a vein doctor who determines the cause to achieve lasting results. Our Midtown Manhattan vein center treats venous insufficiency comprehensively, eliminating the problem and the symptoms.

Vein Treatment Options

Endovenous Ablation

Also Known As: Radiofrequency ablation, ablation, laser ablation

Best For: Big varicose veins, chronic venous insufficiency, and symptoms like heaviness, fatigue, cramping, restlessness, and pain.


What Is Endovenous Ablation?

Leg veins are supposed to route deoxygenated blood toward your heart to retrieve oxygen. If a valve fails inside these veins, blood accumulates in the veins or flows in reverse. As pressure builds in the veins, they develop varicosities, known as varicose veins, or branch out into the telangiectasias known as spider veins. Endovenous ablation uses heat to close these abnormal veins, typically found just below the skin’s surface.


How Does Endovenous Ablation Work?

A safer, gentler, and more cost-effective solution than surgical stripping or ligation, endovenous ablation is a quick and minimally invasive way to treat large, damaged veins and venous insufficiency. Our NYC vein doctors numb the skin above the vein, and also surround the vein with a numbing solution for optimal comfort. We then insert a small device into the vein that delivers the perfect amount of heat through radiofrequency (RF) or laser (EVLT) energy to close the vein. Destroying these veins has no detrimental impact, as the blood is then re-routed to vital veins that facilitate blood’s circulation. The sealed veins are then scarred shut and absorbed by the body. Ablation has tremendous advantages over surgery and should be a first line of treatment at any NY vein center. It takes just 15-30 minutes and is performed in-office, typically while you’re awake. Patients can head back to work or resume activities immediately following the procedure. Ask our Manhattan vein specialists about RF ablation and laser ablation, and why we tend to prefer RF. We’ve performed countless ablative procedures and love providing answers to your questions.


Considerably safer, cheaper, and more efficient than surgery, radiofrequency ablation is highly effective against vein disease. It eliminates downtime and has a 10-year safety record. Insurance often covers ablation, which is one more reason our NY doctors recommend this method.

Pros Summary: 

  • Eliminates downtime
  • Less invasive, yet more effective than surgery
  • Most patients receive insurance coverage
  • Safer and gentler than stripping or ligation


Results of endovenous ablation vary based on the machine used and the doctor’s level of training with the machine. The method’s popularity led to the manufacture of machines of varying quality. Always choose a reputable vein doctor with extensive experience in ablative therapy. Since the procedure involves a precise application of tumescent anesthesia around the vein walls, you need a doctor with a trained hand to prevent discomfort. The experts at New York Vein Treatment Center are distinctly trained in ablative procedures and use only state-of-the-art machines. 

Cons Summary: 

  • Trained hand and precision required
  • Machines vary in quality, affecting results
  • Tumescent anesthesia can cause swelling

Is Endovenous Ablation a Good Option for You?

Endovenous ablation is one treatment our NY vein doctors prefer (particularly RF ablation, since it’s more comfortable than laser ablation). The safety profile, convenience, and insurance coverage make it an excellent choice for most patients.


Also Known As: Vein glue 

Best For: Venous insufficiency and accompanying symptoms like discomfort, leg fatigue, achiness, cramping, and a restless feeling in the legs. 


What is VenaSeal?

Recently introduced by the reputed scientists at Medtronic, VenaSeal employs cyanoacrylate glue to seal damaged veins shut, instead of thermal energy. Long used by doctors in other procedures, it boasts an established safety profile, prompting its implementation in vein disease treatment. 


How Does VenaSeal Work?

This new technology uses ultrasonography to find the problematic vein. Our NYC vein doctors numb the desired entry point on your leg and deliver a small amount of medical grade glue through a catheter to the vein. The ultrasound assists the doctor in the positioning of the tip that releases the cyanoacrylate into the vein. Once the vein glues itself together, the solution hardens and the vein is absorbed by the body, thereby directing blood flow to veins that are working correctly.


There is no swelling with VenaSeal, since tumescent anesthesia is not needed. The cyanoacrylate travels into branches of veins, potentially sealing several defective offshoots with a single application. 

Pros Summary: 

  • Cutting-edge procedure
  • Travels to multiple diseased branches
  • New option for veins subjected to prior treatments


VenaSeal is quite new, which means we don’t know the impact over the course of a patient’s lifetime. Certain patients might be allergic to the glue. Some patients don’t like the thought of the glue hardening and staying in their body. Only certain insurance carriers cover VenaSeal, so the price varies by patient. 

Cons Summary: 

  • New technology, lifetime impact unclear
  • Few insurance companies cover VenaSeal
  • Glue stays in the body
  • Certain patients have allergic reactions

Is VenaSeal a Good Option for You?

VenaSeal should be considered by patients who have treated their veins before. Ask your doctor to test your allergic propensity prior to injecting VenaSeal. Ask our insurance specialists if VenaSeal is covered by your provider so your procedural costs are clear.


Also Known As: Saline injections, cosmetic sclerotherapy, STS, salt solution injections

Best For: Small varicose veins or spider veins 


What Is Sclerotherapy?

This technique injects an irritant directly into the affected vein. The sclerotic substance causes the vein’s collapse, making it smaller and lighter. Once closed, blood can no longer flow into the vein, so it begins moving in the right direction again.  


How Does Sclerotherapy Work?

Our Manhattan vein doctors check for spider veins and varicose veins at the surface and use ultrasound machines to detect deeper problematic veins. We then insert a small needle into the vein, using ultrasound guidance as needed, and inject a sclerosant that irritates the vein lining, causing it to cave in and shift blood flow into thriving veins. Doctors can use different medicines as irritants, including hypertonic saline, one of the original salt-water sclerotic solutions. But our doctors use the newer sclerosants which are much more comfortable for patients.



The liquidity of sclerosants allows them to circumnavigate the tortuosity of varicose veins. The catheter used in endovenous ablation can’t target those twists and turns. In addition to navigating varicose veins, sclerotherapy also treats saphenous spider veins quickly and easily.  

Pros Summary: 

  • Quick and effective resolution of spider veins
  • Navigates tortuous veins better than ablation 


Doctors can choose from a variety of sclerotherapy options which vary in price and efficacy. Each type has certain pros and cons, and even different formulations. Many liquid sclerosants must be diluted for proper dosing. The right dose varies by patient, and some doctors aren’t trained in accurate dosing. If a vein doctor uses substandard medicine or doesn’t mix it correctly, patients can experience pain and discoloration of their skin. A more serious complication, called necrosis, occurs when the doctor mistakenly injects muscles or arteries instead of the vein. That’s why it’s important to choose a qualified center like New York Vein Treatment Center for sclerotherapy.  

Cons Summary: 

  • Requires a board-certified doctor to avoid complications
  • Quality of sclerotic solutions varies

Is Sclerotherapy a Good Option for You?

Sclerotherapy is an excellent solution, particularly if ablation and VenaSeal aren’t options for you. Sclerotherapy is also advised for patients without venous insufficiency who want to reduce the visibility of superficial veins.

Foam Sclerotherapy

Also Known As: Vein injections, foamed sclerotherapy 

Best For: Large varicose veins and small varicose veins


What Is Foam Sclerotherapy?

Foam sclerotherapy also closes damaged veins, with a few distinct advantages over liquid sclerotherapy. When liquid sclerosants enter the vein, they’re diluted by blood. In contrast, foam displaces the blood, coating the walls of the vein directly. As such, a lower concentration of medicine can be used to treat the vein. Additionally, liquid sclerosants can produce four to five times their volume when agitated to form gas bubbles. Most sclerosants are detergents that foam up nicely when mixed with air. The vein expert can fill a larger vein using less medicine when it’s converted to foam, keeping dosages low. Foam is also easier for vein specialists to track, which enhances efficacy.    


The Procedure

Doctors locate the vein, often through ultrasound, and prepare the skin for injection. Since bubbles begin to dissipate quickly, trained doctors know to mix the foam immediately before injection by passing the sclerosant rapidly between two syringes. Once the foam is inside the vein, your doctor will watch its movement via ultrasound to ensure it fulfills its duty. 


Foamed sclerosants are impressive at reaching tight spots in tortuous veins. Foam therapy is also a valuable tool for patients whose veins have been treated before. 

Pros Summary: 

  • Superior movement through twisted veins
  • Gentle solution for chronic vein disease


Foam is so adept at moving through veins that it can travel into connected perforating veins if the doctor doesn’t map out your venous connections. It’s critical to keep the foam out of these deeper veins, so an experienced physician, like our New York vein doctors, will always look for these connections before they inject the foam.

Cons Summary: 

  • Risk of damaging deeper veins if connections aren’t assessed

Is Foam Sclerotherapy a Good Option for Me?

If your varicose veins or reticular veins (smaller and less raised, but still ropy and visible) are bothering you, foam sclerotherapy is an excellent cosmetic solution. But it’s also advantageous for veins that have been treated with other methods, and for the underlying venous insufficiency that causes them. 

Pre-Mixed Foam Sclerotherapy 

Also Known As: Foamed sclerotherapy

Best For: Big varicose veins, chronic venous insufficiency, and symptoms like cramps, achiness, heaviness, swelling, and fatigue


What Is Pre-Mixed Foam Sclerotherapy?

This technology enhances foam therapy by eliminating potential for error in the agitation process. Sometimes foam sclerosants cause air embolisms which impair the oxygenation and travel of blood, when mixed with air in the room. Pre-mixed foam arrives at the doctor’s office in a sealed canister already prepped for injection with the ideal combination of CO2 and nitrogen to eliminate embolisms. This formula accelerates the foam through the bloodstream, deactivating it rapidly to optimize results and safety. 


How Is Pre-Mixed Foam Sclerotherapy Performed?

Once your doctor has isolated the defective vein, they’ll inject the pre-mixed foam through a tiny needle or through an ultrasound device if the vein is a bit deeper. Rather than agitating the liquid irritant to create foam, the doctor injects the pre-made foam from the storage canister. 


Pre-mixing the foam makes it extra effective, particularly for recurrent vascular disease. When performed by a trained vein doctor, it’s a safer, gentler, and faster alternative to surgery.

Pros Summary:

  • Extremely effective
  • Safer, quicker, and less invasive than surgery
  • Powerful against recurrent vascular disease


The formulation of pre-mixed foam is highly potent, so it requires more experience than other methods. This newer version of sclerotherapy isn’t always covered by insurance, so it’s important to choose a vein center that determines your coverage before treatment. 

Cons Summary: 

  • Its potency demands expert precision
  • Your insurance plan might not include it

Is Pre-Mixed Foam a Good Option for Me?

Pre-mixed foam sclerotherapy is not only a safe and powerful alternative to other forms of sclerotherapy, but it’s also advised over surgery for some patients. While this procedure is costly, if your insurance plan covers it, it’s more affordable than surgery.


Also Known As: Mechanochemical Ablation

Best For: Treating the underlying cause of spider veins and varicose veins (venous insufficiency) as well as relieving discomfort, leg fatigue, cramps, heaviness, and restless legs


What Is ClariVein?

This technology delivers a “one-two punch” to the vein, first inducing mechanical trauma to the vein wall, then following that with a sclerosant to induce venous closure. ClariVein administers this technique through a small catheter with a rotating fiber that delivers both types of damage to destroy the unhealthy vein. 


How Is ClariVein Performed?

Once your doctor has cleaned the area and located the vein through ultrasound, they will numb the skin where the catheter will enter. The device is directed into the vein, where it begins to rotate and then secrete a sclerosant, both of which traumatize the vein. In contrast to radiofrequency ablation and sclerotherapy, ClariVein uses two modes of action to enhance results. 


ClariVein doesn’t leave an implant behind like VenaSeal. It does not use the tumescent anesthesia required in ablative therapy. The small catheter can access twisted veins. 

Pros Summary: 

  • No swelling from tumescent anesthesia
  • No implant remains in the body
  • Small fiber reaches tortuous areas


Sometimes complications occur with ClariVein when a doctor can’t easily move the catheter through a valve in the vein. This can be very uncomfortable. Also, insurance companies don’t always pay for ClariVein. 

Cons Summary: 

  • Insurance might not pay for ClariVein
  • Discomfort possible when passing through venous valves

Is ClariVein Right for Me?

If you’re allergic to lidocaine, or uncomfortable with the thought of glue in your body, you might prefer ClariVein over RF ablation or VenaSeal. Be sure to ask your doctor about insurance coverage and about how to achieve good results with ClariVein.


Also Known As: Vein ligation, vein stripping, phlebectomy

Best For: Larger varicose veins 


What Is Vein Stripping?

Vein stripping exposes the diseased vein through an open incision in the leg, whereby the doctor uses surgical tools to extract it. 


How Is Vein Stripping Performed?

After ultrasonography locates the vein, the patient is given general anesthesia and taken to an operating room. A vein doctor will perform a “cut down” into the skin above the vein, so they can locate it firsthand. The surgeon will then pull the entire length of the vein from the body (stripping), commonly with a hook, or cut away a portion (ligation), and then stitch your incision closed.


For patients with the largest, most tortuous veins, or with a history of blood clots, surgery might be the best choice.

Pros Summary:

  • In limited cases, there’s no alternative to surgery


Surgery presents more complications and is more painful, costly, and time-consuming than minimally invasive solutions which don’t require any recovery time. The doctors at New York Vein Treatment Center don’t recommend surgery unless it’s the only choice. 

Cons Summary: 

  • Minimally invasive solutions supersede surgery in many ways for most patients

Is Vein Surgery Right for Me?

Doctors might recommend surgery for patients with blood clots. 

But in general, our NYC doctors don’t suggest surgical stripping unless all other methods have failed or your vein is too torturous to be treated with other techniques. 

It’s important for patients to understand the causes, symptoms, and treatments of spider and varicose veins to achieve lasting relief. If you’d like to know more, contact the vein specialists at New York Vein Treatment Center with your questions. Our board-certified doctors are as skilled at educating patients as they are at administering treatment.

So How Do You Know Which Vein Treatment Option Is Best for You?

Deciding which vein treatment to try is confusing for most patients. Choose a qualified doctor at an accredited center to help you make the right choice. You deserve a doctor who will customize your treatment plan, combining techniques if needed. Don’t begin treatment without first determining whether your doctor is qualified to treat you. Here are five things to require of your chosen provider:

  1. The vein doctor hears and answers your questions: It’s surprising how many patients feel their doctor doesn’t listen to them. Some vein centers schedule doctors in such tight blocks that they don’t have time to really listen. This is not only frustrating for patients, it’s also dangerous. At New York Vein Treatment Center, we want to know everything about your symptoms, concerns, and medical history to devise the best treatment plan. We take time to get to know each patient and answer every question.
What are the internet’s top 10 at-home remedies for vein disease? We talk through these remedies and explain why you should seek vein treatment near me NYC instead

2. The vein center investigates beneath the surface: Some veins, like spider veins, seem like a cosmetic issue. But a top vein doctor knows to check for underlying problems like venous insufficiency. Finding the source of the problem is key to preventing those veins from appearing over and over again.

3. The vein specialist is proficient in ultrasonography: The latest treatments utilize ultrasound technology from start to finish. Duplex ultrasound scans identify problematic veins, and ultrasound guidance ensures both the proper placement of treatment devices, and the complete resolution of the problem. Choose a doctor who’s trained to execute ultrasound treatments, rather than one who relies on an ultrasound technician.

What is the cost of vein treatment near me Midtown?
Dr. Juan Montoya Vein Specialist in NYC

4. The vein center is fully accredited: Only the best vein centers in NYC receive recognition from the intersocietal accreditation commission, or IAC. This stamp of approval is evidence of New York Vein Treatment Center’s superior quality and safety standards, as well as the quality of our doctors and equipment.

5. The vein treatment plan is tailored to you: Vein health, vein connections, and vein symptoms vary widely between individuals. Vein doctors should customize the treatment plan to fit your unique circumstances. There is no single treatment that’s right for everyone, even if they have the same vein disease. Our Manhattan vein specialists take time to design the best plan to restore your venous health, considering your opinions, preferences, and concerns throughout the process. We can even combine multiple methods to achieve your desired results. We take care to keep patients completely informed, every step of the way. 

What is the cost of vein treatment new york?

If you’re looking for the best spider vein treatment or varicose vein treatment in NY, our vein experts will help you select it. Our renowned vein center holds the highest distinctions in vascular care, with IAC accreditation and board-certified doctors. Not to mention, our patients are consistently thrilled by how quick, effective, and painless our treatments are. Visit New York Vein Treatment Center for prompt results that exceed your expectations.

Sclerotherapy vein treatment in San Diego, California. Performed by Harvard Trained Vein Doctors



The vein doctor in NYC numbs your skin’s surface before delivering the sclerotherapy injections, so you feel minimal discomfort.

Sclerotherapy vein treatment in San Diego, California. Performed by Harvard Trained Vein Doctors

RF Ablation


Endovenous ablation with radiofrequency causes no pain and minimal discomfort. You may feel a bit of a pinch as the vein doctor delivers local anesthesia into your skin, but no sensation beyond that. 

Sclerotherapy vein treatment in San Diego, California. Performed by Harvard Trained Vein Doctors



Our vein specialist in NYC applies topical anesthetic on your skin’s surface before delivering the VenaSeal injection, so you feel minimal discomfort during the treatment.

Sclerotherapy vein treatment in San Diego, California. Performed by Harvard Trained Vein Doctors



Our vein experts in NYC administer local anesthesia before the ClariVein treatment, so you feel nothing more than gentle pressure on the treatment regions.

Laser Ablation or EVLT vein treatment in San Diego, California


Iѕ one of several technologies used to treat vein disease, аlѕо knоwn as Chrоnіс Venous Insufficiency.
Not sure if you’re covered or which procedure to choose?

Fill out this form and we will contact you ASAP.

All vein treatments in NY are covered by most health insurance, including medicare. Submit this form to verify coverage and book an appointment. Once you visit us, one of our vein doctors will create the best custom treatment plan for you!

Vein Treatment Overview

Our Vein Doctors in NYC are some of the top experts in vein medicine. At the Vein Clinic Of New York we regularly search for new and novel treatment modalities. If we feel that a new treatment is safe to use in our clinic, we add it to our options to ensure that our patients are getting the least invasive, least painful, and most effective vein treatments available. We consider sclerotherapy, radiofrequency ablation, venaseal, and laser vein ablation to be the best options for most vein disease.

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