Radiofrequency ablation is a minimally invasive thermal treatment for varicose veins. Ablation means a doctor uses heat to damage tissue, which makes scar tissue form. This scar tissue closes the vein. The RFA technique uses radiofrequency energy (instead of laser energy) to heat up and damage the wall inside a vein. This usually closes off a varicose vein in the leg.
To treat a varicose vein, radiofrequency energy is directed through a thin tube (catheter) inserted through a small incision in the vein. Bypassing an electrical current through the catheter inside the vein heat is generated and temperatures of 120°centigrade are attained. The heat produced destroys the vein. As the procedure relies on direct contact between the catheter and the vein wall, the vein needs to be as tightly wrapped around the catheter as possible. This is achieved by using tumescent anesthesia and external compression and the leg is elevated to collapse the vein. There is an electrical feedback mechanism integrated into the RFA fibre which can alter the energy delivery, so as to maintain a constant temperature within the vein.
After treatment, you will wear compression stockings for 1 week or more. To follow up, your doctor will use a duplex ultrasound to make sure that the vein is closed.
RFA Machine and Fibre From Covidien/Medtronic, USA
There are many options for the treatment of diseased veins and your best option is dependent upon the severity of your condition, your preference and desired outcomes. Radiofrequency Ablation Endovenous Therapy and Endovenous Laser Treatment (EVLT) are both done in office under a local anaesthetic. Each procedure utilizes the use of ultrasound technology to guide a thin catheter bearing an optical fibre through the vein to the area of treatment. The difference lies in the heat source used to treat the vein. For Radiofrequency Ablation Endovenous Therapy, radiofrequency energy is used to heat and close the vein wall, while during EVLT laser heat is used to achieve the same outcome.
Following the heat exposure, the treated veins will form scar tissue closing off the vein and blood flow, eventually causing the vein to atrophy and fade. With advances in technology and fibres, the pain during the procedure and post procedure is minimal in both. Recovery for both techniques is similar in that patients are asked to walk around shortly following the procedure and wear compression stockings for one to two months.
In summary, EVLT and Radiofrequency Ablation Endovenous Therapy are similar in nature but differ in the technology used.
It is important that the procedure is performed by an expert, who has thoroughly evaluated the patient, and is very well experienced in the technique. It is also important to note that every patient of Varicose veins is different, and no one procedure can be used to successfully and adequately all patients. The type of procedure performed is at the discretion of the treating doctor, who may even use one or more techniques to give the best result.
Dr Shoaib Padaria has over 30 years of experience in treating Vascular Diseases, and over 17 years in treating veins by Endovenous methods. The first documented case of Endovenous Laser for varicose veins was performed by Dr Padaria at Jaslok Hospital on 6th January 2003. Since then he has performed more than 16000 treatment procedures. Dr Padaria is well versed in all modern techniques of Varicose Veins treatment, and is part of many teaching courses and workshops, both Nationally and Internationally
69 years old male patient Mr. LL, presented with pain & swelling for many years which gradually developed into a non-healing ulcer for 1 yr in the right leg. Venous Doppler Study revealed S-F junction incompetence, refluxing GSV, SSV & Superficial varicosities, which was treated using an Endovenous RFA & Sclerotherapy procedure followed by a regular dressing of the wound. The ulcer healed well & the varicosities disappeared within a month.
53 years old housewife, Mrs. R J presented with pain and swelling in Left leg for 10 yrs. Also, she has Burning, night cramps, large varicosities in the medial leg. Venous Doppler study demonstrated S-F junction incompetence, refluxing GSV & Superficial varicosities. The GSV was ablated using the Endovenous RFA procedure. Large varicosities in the posterior calf were removed with a micro-phlebectomy procedure. With this treatment, the varicosities disappeared within a month with relief of symptoms.
47 years old Male patient Mr. PJ, who has a business that involves standing of 8-10 hours daily, presented with pain in the Right leg & pigmentation of skin around the ankle for 3 Yrs. Venous Doppler study revealed S-F junction incompetence, refluxing GSV, Superficial varicosities & Incompetent perforators. The GSV was ablated using the RFA procedure. Superficial varicosities were closed with foam sclerotherapy and incompetent perforators were closed using Laser procedure the varicosities disappeared within a month.
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