Thermal Ablation: Radiofrequency (RFA)

Thermal Ablation: Radiofrequency (RFA)

This is a minimally invasive technology to treat venous disease that has now largely replaced traditional surgery. This is done under local anaesthesia and patients can go home the same day. No hospital admission is required. Patients can return to normal daily activities by the next day.

The traditional treatment of treating a refluxing vein (More About Vein Stripping) entailed surgery and ‘vein stripping’ or removal of the vein. This required hospital admission and a general anaesthetic. Surgical incisions are then made in the groin and at the knee and the offending vein is literally stripped out. The body is then able to use the deep venous system to return blood to the heart.

This is done under general anaesthetic, requires hospital admission and, although still may have a role in the individual patient, has generally been replaced with newer, quicker, less invasive and more pain-free techniques.

Today we have the option of Endovenous Techniques, including Radio Frequency Ablation. This is a procedure that also addresses the refluxing vein with the same outcomes as surgery however:

  • does not require hospital admission
  • does not require a general anaesthetic
  • does not require surgical incisions to address the vein
  • allows the patient to go home the same day
  • allows the patient to return to normal activities the same day
  • decreases pain and discomfort post procedure

There have been 4 randomised controlled trials comparing RFA to open surgery and RFA was significantly better in all of the following:

  1. less post-operative pain
  2. quicker recovery
  3. higher quality of life scores
  4. less bruising

Patients who underwent RFA were able to return to work more than one week earlier than those who underwent surgery. Eighty one percent of patients who underwent the RFA procedure returned to normal activities within one day whereas only 47% of those who underwent surgery were able to do this.

To view how the procedure is done view here:

1What does RFA entail?
Under ultrasound guidance, the RFA catheter (a small, thin, flexible tube) is inserted into the vein and activated, thereby sealing off the vein.
2Is it Painful?
RFA is performed under local anaesthetic which is given using a very fine needle in multiple areas. Most patients tolerate this well with no other analgesia or sedation required. If it is required, additional sedation or analgesia may be given. Pain is minimal post procedure.
3Are there any complications?
As for any procedure, there is a risk of complications. These are very uncommon following the RFA procedure, and if they occur are usually temporary. These will be fully explained, should you need the procedure
4When can I go back to work / resume normal activities?
Most patients return to normal activities the following day. If a patient has phlebectomies done, recovery may be slightly longer.
5Does the procedure have as good results as surgery?
Yes! Symptom relief and recurrence equates to surgery. All with a far less painful procedure and higher patient satisfaction.