What is it about?

Varicose veins are often treated with laser. This is called endovenous laser ablation (EVLA) and is one of the first-line recommended treatments for varicose veins. Over the years different lasers have been used. Initially, doctors used 810 nm, but this is not very good because it heats blood. When patients are lying down and have local anaesthetic around the vein, there is rarely blood in the vein. Hence the "industry standard" is the 1470 nm laser which heats water in the cells of the vein wall. Over the last year or so, a new laser using 1940 nm has been promoted heavily. This laser has a much greater affinity for water. This has led some companies to claim that less energy can be used to get the same effect. They have reported that this would lead to less pain. Unfortunately for those claims, this research shows that when using either of these lasers at the powers needed to close leg varicose veins, they have virtually identical effects on tissue. Therefore there is no advantage to either one. However, this research did show that when using very low powers, such as the new technique we have invented for treating prominent vertical forehead veins, the new 1940 nm wavelength does have an advantage over the standard 1470 nm.

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Why is it important?

It is very important that doctors are able to choose the best equipment to treat their patients. To do this, doctors rely on accurate information regarding different devices. Obviously, companies try to sell their equipment by outlining positive advantages to using their products over equipment being sold by competitor companies. This often means that marketing claims are made that either cannot be substantiated, or are difficult to substantiate. In order for doctors to be able to make the best decisions, they need the best independent scientific evidence that is available. At The Whiteley Clinic, we have a reputation for performing independent research and publishing results, regardless of whether it is useful for certain companies or not. We do this to ensure that we offer our patients the very best treatments available, based upon the best science available, and we share this information with other doctors through research papers. This sort of information is essential so that doctors can compare independent scientific findings with marketing messages from different companies so that they know who they can trust and what products are best for their patients.


This research is the latest in a series of projects that have spanned almost 2 decades at The Whiteley Clinic, all with the aim to understand the best treatments for leg varicose veins and venous leg ulcers. We have an ongoing research ethos where we look at all of the latest techniques and devices to treat veins, in order to see what is optimal and what is not. We look at manufacturers claims and then perform independent scientific experiments to find out what the actual scientific basis for any claims are. In this particular case, we found that the claimed advantages for leg varicose veins do not make scientific sense. We cannot see any scientific reason why the new 1940 nm laser would have the same effect at lower total energies than the standard 1470 nm laser, when used at the powers needed to treat leg varicose veins. Hence any reduction in pain is likely to be mirrored by a reduction in efficacy. However, it was very interesting to find an advantage of the new 1940 nm laser when using low powers. This showed an advantage when using the new wavelength in very small veins, particularly in the new area of "aesthetic phlebology". When we treat veins near the surface, such as the vertical bulging forehead veins, we want the lowest risk of causing skin burns. Therefore we want a laser that interacts with the vein very efficiently, causing less thermal spread and less chance of damage to the skin. This is exactly what we found with the 1940 nm laser. Since performing this study, we now only use the new 1940 nm laser to treat aesthetic veins such as vertical forehead veins. This is an example of how we use the results of our research for the benefit of our patients, as soon as those results are available.

Professor Mark S Whiteley
The Whiteley Clinic

Read the Original

This page is a summary of: No significant difference between 1940 and 1470 nm in endovenous laser ablation using an in vitro porcine liver model, Lasers in Medical Science, October 2021, Springer Science + Business Media,
DOI: 10.1007/s10103-021-03449-0.
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