Endovenous Radiofrequency Ablation (RFA): Is It Right for You?

If you’ve started looking into treatments for your varicose veins, you may have come across endovenous radiofrequency ablation. But what is radiofrequency ablation, and how does it work to eliminate varicose veins?

Radiofrequency ablation (RFA) is a complex term for a relatively simple and straightforward process. Entering the vein through a tiny catheter, it uses safe radiofrequency energy to heat up and seal varicose veins. The vein seals itself shut and the blood naturally rediverts through healthy veins in the area. 

RFA works best on varicose veins that are closer to the surface and have fewer natural bends. That’s because it uses a thin tube called a catheter, which has a harder time passing through veins with more twists and turns.

RFA is most suitable for people who have larger and more concentrated varicose veins. If your affected veins are smaller or more widespread, you may be more suited to a different treatment such as sclerotherapy. RFA is also not suitable for patients who:

• ‌Are pregnant
• ‌‌Have a history of blood clots
• Have a skin infection in the affected area
• Have limited mobility

‌A vein specialist can help you to understand if radiofrequency ablation is a good choice for you. For now, let’s look at RFA in general, starting with how it compares to traditional surgical treatment. 

RFA  Treatment vs. Surgery: Benefits and Drawbacks of RFA

Before RFA and other minimally invasive procedures were developed, surgery was the go-to treatment option for varicose veins. The surgical treatment is called vein ligation and stripping. It requires the surgeon to tie off and remove the affected vein.

Both vein stripping and RFA are effective, but RFA offers several advantages in terms of the patient experience.

The Advantages of RFA

Research has shown that compared to traditional vein surgery, RFA:

• ‌‌Allows patients to recover more quickly with fewer side effects
• Has a lower risk of complications
• Is less invasive and less painful 
• ‌Requires less follow-up care
• ‌‌Usually only requires local anesthetic

The Disadvantages of RFA

No treatment is better in all circumstances. Another treatment type may be preferable if a person isn’t a candidate for RFA.

Also, RFA may be more expensive than other treatment modalities. Talk to your vein specialist about pricing if you need to pay out-of-pocket or if you have insurance limitations.

What to Expect with RFA Treatment

RFA is usually an outpatient procedure, meaning that you can usually have it done in a doctor’s office without ever having to visit a hospital. The treatment office will include all of the equipment the specialist needs, such as:

• ‌An ultrasound scanner
• ‌A catheter — a thin plastic tube usually about 1/8 inch in diameter
• ‌A computer console that controls the electrodes
• Radiofrequency electrodes — long, thin wires that pass through the catheter to the vein‌

The RFA Procedure

To perform radiofrequency ablation for varicose veins, a vein specialist:

1. ‌Cleans, sterilizes, and covers the treatment area — then numbs the spot where the catheter will enter the skin.
2. ‌Maps out the vein using a handheld ultrasound device.
3. ‌Makes a tiny incision in the skin, just large enough for the catheter.
4. ‌Inserts the catheter and place it inside the affected vein, then passes the electrode through the catheter.
5. ‌Pulls the catheter back slightly to expose the tip of the electrode, where the energy comes from.
6. ‌Injects local anesthetic to numb the abnormal vein.
7. ‌Introduces heat to the electrode to cauterize — warm and close — the vein.
8. ‌Withdraws the catheter and applies pressure to control any bleeding, which is usually minimal.
9. ‌Places a small bandage over the incision to end the procedure.

The entire procedure usually takes about an hour. You may feel slight pressure from the catheter and a prick when you receive the anesthesia, but the procedure itself shouldn’t be painful. 

The Results of RFA

RFA is a proven effective treatment for varicose veins, but don’t expect to see the affected veins disappear instantly after the procedure. 

It’s common for results to take weeks to become apparent. You may notice an improvement in your varicose veins within weeks of having the procedure, but the full effect may not be visible for a few months. Most treated veins are invisible a year after the procedure.

Treated veins should not “come back,” but it may take more than one session to treat all of your affected veins. 

Aftercare for Vein Ablation

Most people can return to their day-to-day activities immediately following RFA treatment. Gentle physical activity is important because it keeps the blood flowing and reduces the risk of complications.

Your vein specialist will probably advise you to avoid sitting down for long periods. That usually means avoiding air travel and long car trips for a few weeks.

You can also expect to wear gradient compression stockings after the procedure, both to improve circulation and prevent complications. Gradient compression stockings work by applying consistent pressure to the lower legs, encouraging the blood to flow in the correct direction back to the heart.

Gradient compression stockings also help to reduce bruising and tenderness around the treatment site. This is a common but temporary side effect.

Some people also experience swelling called phlebitis around the treatment site. This happens in about one out of every 20 patients. Ice and non-steroidal anti-inflammatory medications like ibuprofen can help.

Finding a Specialist

Choosing a varicose vein treatment is a personal decision. If you have more questions about varicose vein ablation, or if you’d like to get more personalized information about the procedure or how much it would cost, talk to a vein specialist.

My Vein Treatment’s locator tool makes it easy to find a vein specialist in your area. Reach out today and get one step closer to varicose vein relief.