The European College of Phlebology guidelines published in 2020 give the highest grade for treatment of great saphenous vein and short sapheenous vein refux with endovenous laser therapy (EVLA) and RFA.
Class of recommendation for EVLA ablation of Great Saphenous vein is the highest, namely Class I and the level of evidence for this recomendstion is Grqde A,
Definitions:
Class I recommendations are strong and indicate that the treatment, procedure, or intervention is useful and effective and should be performed or administered for most patients under most circumstances. Class II recommendations are weaker, denoting a lower degree of benefit in proportion to risk.
Grade A evidence is "strong evidence" and "Clinicians should follow a strong recommendation unless a clear and copelling rationale for an alternative approach is present".
Dr Karamanoukian: It is nice to see that the European College of Phlebology has given a Class I recommendation for endovenous laser ablation of the great saphenous vein and a Class I recommendation for endovenous laser ablatioon of the shart (small, lesser) saphenous vein. This is the highest recommendation and is based on Level A scientific evidence.