What is Radiofrequency Ablation?

Varicose veins can make life miserable. These bulging, discolored veins are usually found in the lower body and may come with health-related concerns. Fortunately, there is a minimally invasive solution: radiofrequency ablation.

Radiofrequency ablation, abbreviated RFA, is also sometimes used to treat a variety of chronic pain symptoms. So, what is radiofrequency ablation and how can it help you with varicose veins? Let’s find out.

The Veins and Radiofrequency Ablation

Normally, blood cycles through the body in a prescribed way: the heart pumps it out through arteries and veins return it to the heart. For areas below the heart, especially the legs and feet, veins are fighting gravity to bring blood back to the heart. To succeed, the veins rely on surrounding muscle to push blood up and have a series of one-way valves that close to prevent backflow.

For people with varicose veins, these valves don’t work correctly. Blood may leak the wrong way, making it pool up in the leg veins. This causes the veins to bulge and twist.

The goal of radiofrequency ablation is not to change these valves, but rather to close these veins altogether and divert blood flow to other, healthier veins. It does this using radiofrequency energy, which heats the vein and damages the wall inside it, causing it to scar over and eventually close.

Preparing for Procedure

There are a few simple preparations to take before you undergo RFA treatment:

Doctor meeting: You will meet with a specialist to discuss any risks or potential complications with the treatment. You’ll report all medications you’re taking and any allergies or reactions you’ve had in previous treatments (especially to anesthesia).
Clothing: Wear loose, comfortable clothing to the procedure. You’ll also be required to wear compression stockings for at least a week, so bring these with you to the procedure. When you schedule the procedure, your doctor will discuss which type is required.

During the Procedure

There are a few general steps to RFA treatment, which should take around 45 to 60 minutes:

Mapping: Using ultrasound imaging, the doctor will identify the veins to be treated.
Preparation: The areas that need to be treated will be shaved, cleaned and sterilized. Then they’ll be covered with a surgical drape.
Anesthetic: The doctor will determine the best area to insert a catheter, a plastic tube that will help administer the radiofrequency waves. This area then receives local anesthetic.
Insertion: The catheter is inserted through a small 2mm incision in the skin, and positioned in the correct place.
More anesthetic: At this point, another local anesthetic is injected around the vein itself.
Application: Radiofrequency energy is sent into the vein.
Final steps: The catheter is removed, and dressing is given to the small cut. Compression stockings should be worn immediately after treatment finishes.

Post-Procedure

You’ll be instructed to wear compression stockings for at least a week after RFA treatment, and you’ll receive a duplex ultrasound as a follow-up to make sure the vein is completely closed – you may have to have another treatment if it’s not. You should plan to walk for at least 30 minutes after the procedure and frequently throughout each day.

Safety, Effectiveness and Side Effects

Radiofrequency ablation is successful in closing off veins in over 95 percent of cases. Despite the high efficiency rate, there are a few possible side effects of RFA treatments:

Burns
Swelling or bruising
Numbness: May last for a few months in the treated area
Superficial phlebitis: a form of inflammation that could last for up to 10 days
Deep vein thrombosis: blood clotting in the vein
Painful prickling or burning sensations after recovery
Infection at the injection point (very rare – only seen in under 1 in 1,000 patients)
Heat damage to nerves near the veins (also rare, usually goes away in 3-6 months)

If you’re worried about varicose veins, and other treatments have not been successful, speak to your doctor about whether radiofrequency ablation is a good choice for you.