Radiofrequency Ablation (RFA) for Varicose Veins

Radiofrequency ablation, or RFA, seals a leaking vein from the inside using controlled heat from a fine catheter. Like laser treatment, it is a NICE-recommended first-line treatment for varicose veins. At Anglia Vein Clinic, we perform it as a day case under local or general anaesthetic.

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How RFA treats varicose veins

Leg veins carry blood upwards against gravity, kept moving in one direction by one-way valves. When a valve fails — most often at the groin or behind the knee — blood falls back down the vein and pools. This is reflux, which stretches the veins beneath the skin into visible varicose veins.

RFA closes the faulty trunk vein at its source. Blood is then redirected into the healthy deep veins, which already carry most of the blood from the leg. Closing the diseased vein does not deprive the leg of circulation.

 

Who is suitable?

RFA suits most people whose varicose veins arise from a leaking great or small saphenous vein that is reasonably straight. Your duplex ultrasound scan, done standing, shows exactly which veins are leaking, how large and how deep they are, and whether RFA, laser, or another technique best fits your anatomy. You will be shown your own scan findings and what they mean before any treatment is discussed.

 

The procedure, step by step

1. We map and mark your veins while you stand.

2. After local anaesthetic (or general anaesthetic if you prefer), a thin catheter is passed into the vein through one needle puncture, usually near the knee or ankle.

3. Tumescent anaesthesia — a dilute local anaesthetic solution — is placed around the vein to numb it and protect the surrounding tissue.

4. As the catheter is withdrawn, it heats the vein wall in short segments, and the vein seals shut. Over the following months, it shrinks and is absorbed.

5. The doctor applies bandages and a compression stocking, and you walk out soon after.

Treatment takes 45 to 90 minutes per leg. Bulging branch veins can be removed at the same session through 2–3 mm punctures, or treated with foam.

 

Benefits compared with traditional surgery

Compared with the old "high tie and stripping" operation under general anaesthetic, RFA:

• needs only a needle puncture rather than a groin incision

• can be done under local anaesthetic as a walk-in, walk-out procedure

• causes less pain and bruising

• allows a quicker return to normal activity — desk work after 48 hours for most people

Traditional surgery remains a very effective option for some complex cases, and we offer it when anatomy demands it.

 

After your treatment

The stocking stays on day and night for 48 hours, then the outer bandages come off, and you put the stocking back on for another five days and nights, then daytime only for two weeks. Walk for five to ten minutes every hour while awake. Avoid driving for 48 hours, and flights for two weeks (four weeks for flights over four hours). The recovery and aftercare guide has the full timetable.

 

Risks

Bruising, tenderness and firm, tender lumps along the treated vein are common and part of normal healing. Temporary numbness or tingling occurs after about 1 in 30 thermal ablations. DVT occurs in 1 in 100 to 1 in 300 cases, usually as a small clot seen only on routine follow-up scans, and pulmonary embolism is exceptionally rare, at under 1 in 1,000. Skin burns are around 1 in 1,000 and almost always small and self-healing.

Varicose veins can recur over the years because valve failure tends to continue. Published studies suggest some recurrence in roughly 6 in 100 patients at one year and more than 20 in 100 by five years, depending on the treatment and anatomy. Recurrence caught early is usually a small procedure.

 

RFA or laser?

RFA and EVLA work on the same principle and give very similar results. Mr Prionidis will recommend one based on your scan.

 

Book an assessment

Your consultation, scan review, treatment and follow-up are all with the same consultant. We see patients at Springfield Hospital and Phoenix Hospital in Chelmsford, St Edmunds Hospital in Bury St Edmunds, and Weymouth Street Hospital in London.

No referral is needed. Call 01245 241 340 or email info@avclinic.co.uk.