Radiofrequency ablation for varicose veins

Radiofrequency ablation is a newer, minimally invasive, treatment for varicose veins. (Ablation means a doctor uses heat to damage tissue, which makes scar tissue form. This scar tissue closes the vein.) This 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. It can be used on large veins in the leg and can be done in an office setting using local anesthesia or a mild sedative.

Is it safe?

Possible side effects of radiofrequency ablation include:

• Skin burns.
• Feelings of burning, pain, or prickling after recovery, from nerve damage (less likely than after vein stripping surgery).
• Small or large blood clotting in the vein or a deep vein (less likely than after vein stripping surgery).

The more experience your doctor has had with radiofrequency, the less risk you are likely to have. Talk to your doctor about how often these side effects happen in his or her practice.

How well does it work?

When done by a doctor with plenty of radiofrequency experience, chances of treatment success are good. Radiofrequency closure works well in about 85 out of 100 people who have it. That means it doesn't work well in 15 out of 100 people.¹

• Pain after treatment is typically less after ablation than after vein surgery.
• After 2 years or more, results from ablation are generally as good as from vein surgery.²
• Veins that do not close are treated again. Choices include another ablation, sclerotherapy, or surgery to remove the vein.

Citations

1. Van den Bos R, et al. (2009). Endovenous therapies of lower extremity varicosities: A meta-analysis. Journal of Vascular Surgery, 49(1): 230–239.
2. Golan JF, et al. (2007). Varicose vein surgery. ACS Surgery: Principles and Practice, 6th ed., pp. 1177–1187. New York: WebMD.