Radio-Frequency Ablation of Varicose veins - RFA
Similar to treatment with Laser, Radio-Frequency Ablation (RFA) is a minimally invasive treatment that does not require the patient to be put to sleep. Also like laser, it is a heat based treatment of the vein from the inside. There is little difference in the outcome or procedure involved between Laser and RFA, although the lower temperatures of RFA tend to make the period after treatment less painful.
RFA is a procedure carried out in a procedure room. The patient undergoing treatment is usually awake throughout the procedure and local injected anaesthetic solution is used to make sure that the treatment area is numb.
Once the patient has got changed into the procedure gown and the legs measured for compression stockings, the patient is taken to the treatment couch and tilted so that the legs are slightly lower than the head.
The leg is cleaned with a sterilising solution and scanned for a suitable vein for access. Local anaesthetic injection is used to numb the area before a needle is introduced followed by a small tube, called a sheath. Through this sheath the RFA device is passed inside the vein up to the top the leg. The position of the device is ensured by continuous ultrasound guidance.
Once in position the patient is tilted slightly head down so that the blood in the dilated veins empties. The collapsed vein and the surrounding tissues are injected from top to bottom with numbing solution before the RFA device is triggered. The RFA device treats 7cm sections all the way down. Once completed, the compression stocking is put on the treated leg and the patient is allowed to mobilise immediately.
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A member of the CVG team will make contact with you in the first 24 -48 hours after to check your progress and to organise an appointment for you for about 6 weeks after the treatment. By that time most of the bruising will have settled and the clinical result can be assessed by your specialist.
Not uncommonly some of the depressurised varicose vein branches will benefit from additional injection treatment to get the best cosmetic result - this is included in the treatment and is virtually painless.
Planning and Assessment
Before RFA you will be seen and assessed by a specialist vascular surgeon and will have had a detailed scan of your veins. The scan is performed to ensure that your veins will be appropriately treated by endovenous methods. Your surgeon will be able to describe the findings of the scan and the radiofrequency treatment. You should feel free to ask any questions about your treatment until you are satisfied that it is right for you. The procedure will be booked on a convenient date by the CVG administrative staff. You will be given all the information you need for your insurance claim but usually CVG can organise approval directly.
Once the treatment has finished and you are up and walking, you will be given instructions on how to manage the after treatment period.
It is important for you to maintain frequent walking exercise, and this should be a regular feature of the weeks after treatment.
The need for compression is variable; you will be give specific instructions depending on the veins that have been treated. Usually, you should wear the provided stocking for the first 48 hours continuously. Following that first period, you should wear the stocking during waking hours for a variable period between 5 and 10 days. Many people find that even after the prescribed period, the compression can help relieve some of the mild to moderate discomfort that is experienced from the treated vein.
Although RFA treatment of varicose veins is well tolerated, there is a period after the first few days and for a period of about 5 days where there is mild to moderate pain, redness, bruising and swelling . Simple analgesia medications is all that should be required; like paracetamol or ibuprofen, both available as over the counter tablets. It is advisable to take these regularly during the first couple of days.