Radiofrequency Occlusion

Radiofrequency ablation is the process of using focused radiofrequency waves to remove living tissue by heating and killing problematic cells. Doctors use radiofrequency ablation to treat a wide range of medical conditions. Since the FDA approved the radiofrequency ablation method known as Venefit (formerly known as VNUS Closure Procedure) in 1999, radiofrequency thermal ablation has become a standard treatment for enlarged leg veins (such as varicose veins).

Radiofrequency ablation for varicose vein removal usually takes between 45 minutes to an hour to perform, and your doctor can perform it in the the office or an ambulatory surgery setting using localized anesthesia.

What is the difference between radiofrequency ablation, endovenous laser therapy, and sclerotherapy?

Radiofrequency ablation, endovenous laser therapy and foam sclerotherapy are all endovenous techniques — they treat problematic veins from within the vein itself. Radiofrequency ablation uses a radiofrequency catheter which is threaded directly into the problem vein to heat and collapse the vein, effectively occluding (closing off) the problem vein. Endovenous laser therapy (EVLT) uses laser energy applied through a thin laser fiber which is threaded into the problem vein. Foam sclerotherapy is performed by injecting an irritant (sclerant) directly into the problem vein, which irritates and scars the vein until it is closed off and reabsorbed into the body. Talk to your doctor about which endovenous technique would best treat your varicose veins.

How is radiofrequency ablation performed?

Before beginning your radiofrequency ablation procedure, your doctor will use ultrasound to map out the veins to be worked on. With clear direction from the ultrasound, your doctor will make a small incision or puncture near the knee and then thread a small catheter into the vein to be treated. Localized tumescent anesthesia (saline-infused anesthesia) will be injected into the vein to numb the area, firm up the area, and make it easier for the doctor to perform the ablation. When the entire vein to be treated has been canalized (fully threaded with the catheter), sound waves will be applied to heat and collapse the vein in segments, beginning from the top down as the catheter is pulled back and out of the vein through the incision. The collapsed vein will close (occlude) and scar up, and eventually it will be reabsorbed into the body. Your body will redirect the flow of blood away from the occluded vein and through healthier venous pathways.

What is the recovery like after radiofrequency ablation?

Compression is vital to the healing process after any venous treatment. Compression reduces bruising, encourages circulation and reduces the risk of blood clots after a venous procedure. After your radiofrequency ablation procedure, your treated leg will be wrapped in compression bandages or stockings. Often your doctor will wrap your untreated leg as well. Your doctor will recommend that you wear compression stockings for a week or two following the procedure. You will be encouraged to walk immediately after the surgery, and you will be discouraged from bed rest and heavy lifting. You will most likely be able to resume normal daily activities within a day or two following the procedure. Be sure to schedule a follow-up appointment within 3-7 days so your doctor can monitor your healing process and check for any complications.

What are the possible complications or side effects of radiofrequency ablation?

Possible complications of radiofrequency ablation are temporary bruising, swelling and numbness. Skin burns are a rare complication, but under the care of an experienced vein specialist, the chances of this are minimal. Sometimes patients are allergic to the anesthesia administered during the procedure. Deep vein thrombosis is an extremely rare complication.

How does radiofrequency ablation compare to endovenous laser treatment?

Patients report slightly less pain and bruising following radiofrequency ablation treatment than are reported by patients who receive EVLT, while success rates of EVLT are reported as just slightly higher than success rates for RFA treatment. Talk to your doctor to determine which endovenous treatment is right for you.

Do insurance carriers provide coverage for radiofrequency ablation treatments?

Many insurance companies cover radiofrequency ablation with the same stipulations they would for any surgical procedure. Conservative treatments such as exercise, weight loss, and compression hose are usually recommended before surgery is considered. Eligibility for radiofrequency ablation is usually determined by the extent of your varicose veins and your medical need. Talk to your insurance carrier to determine your eligibility.

How do I know if radiofrequency ablation is the best treatment option for me?

Consult with an vein specialist who is experienced in performing radiofrequency ablation. After taking a thorough medical history and performing a physical examination, your physician will be able to determine if radiofrequency ablation is the right procedure for you.

What are varicose veins?

Varicose veins are swollen blood vessels in the legs which are caused by a combination of hereditary factors, the buildup of pressure in the veins from prolonged standing, the decrease in vein elasticity as a result of age, and pregnancy in women. Varicose veins appear as thick, twisted veins which appear at the surface of the skin. Many people find varicose veins to be uncomfortable or even painful. Varicose veins often accompany swelling of the feet and legs and sometimes leg cramps.

Occasionally skin will breakdown around the ankles and form slow-healing sores known as venous stasis ulcers.

Reviewed February 9, 2017

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