RADIOFREQUENCY THERMAL ABLATION (RFA)

A simple, non-surgical procedure to treat varicose veins. Radiofrequency Thermal Ablation (RFA), used together with Ultrasound Guided Sclerotherapy (UGS) is a safe, fast, effective way of eliminating unsightly varicose veins with no general anaesthesia, no time off work, and little or no discomfort.

WHAT IS RFA?

RFA involves a combination of radiofrequency energy and ultrasound technology. It is used to close large diseased veins that would previously have been subjected to surgical stripping under general anaesthetic. The blood is then redirected into healthy veins, relieving symptoms.

IS RFA SAFE?

RFA is the new gold standard for varicose vein treatment and has been clinically proven to be safer and less painful than Endovenous Laser Treatment (EVLT). RFA is performed under sterile conditions with local anaesthetic. It is generally well tolerated, and patients can return to normal daily activities immediately.

With RFA, the thermal delivery method does not require laser energy, and there is no need for a general anaesthetic, which carries its own risks. It is important for safety that patients are treated by a team of experienced practitioners.

Doctor Joanna Romanowska, Doctor Jill Gibson, Doctor Karen Parker and your sonographer, Angela, all have extensive experience in the field of varicose vein ablation. All aspects of the treatment use ultrasound technology to ensure accurate identification of the targeted veins.

WHAT HAPPENS BEFORE TREATMENT?

A full medical history will be taken by the Doctor in the consultation, and you will have the opportunity to discuss all aspects of the treatment. The origin and severity of the varicose veins will be assessed during your ultrasound vein mapping.  Angela will point out to you the veins that would be best treated with RFA.

WHAT HAPPENS DURING TREATMENT?

A thin catheter is inserted into the target vein under local anaesthetic, much like having an IV line put in, and more local anaesthetic is placed along the length of the vein. The radiofrequency energy is then delivered into the vein, causing the vein to collapse and seal shut.  The remaining abnormal branch veins are treated using ultrasound guided sclerotherapy injections.  Further injections may be required at follow-up visits.  Following the procedure, compression stockings are applied, and a daily walk is advised.

WHAT POSSIBLE SIDE EFFECTS CAN OCCUR?

Occasionally, some of the following effects may occur after treatment, but all are transient. Wearing compression stockings and sometimes taking anti-inflammatories (like Nurofen), will reduce discomfort:

• A feeling of tightness, “like a bow-string” over the treated vein. This is temporary and will disappear. Before treatment, the vein is stretchy, like a rubber band. After treatment, the treated vein is more like a thick piece of string.
• Hard, sore, lumpy veins. The treated veins contain trapped blood and the tissues around the vein may become irritated. This is called “Superficial Thrombophlebitis”, and is temporary.
• Discolouration: This is caused by pigment leaking from the red blood cells along the course of the treated blood vessels. It happens unpredictably in about 30% of people and has the appearance of an old bruise. Pigmentation disappears over time but may take as long as 12 months to resolve. We know that the use of compression stockings following treatment is essential to minimise the occurrence of pigmentation.
• Vein matting: These are new, very fine, red blood vessels in response to treatment and occur in a minority of patients. Its cause is unknown and it may not be easy to treat.
• Skin Ulcers: These are rare and can occur at the injection site or further away.
• DVT: The risk of DVT is very low but is reduced by correctly wearing compression stockings as prescribed and walking 30-40 minutes per day.
• Infection of the vein & surrounding tissue which needs antibiotics. This is rare.

WHAT AFTER CARE DO I NEED?

• Minimum of 30 minutes walking per day.
• Continue wearing the stockings as instructed.
• Avoid strenuous exercise for 3-4 weeks.
• Avoid sun exposure to the treated areas until all bruising has resolved to prevent pigmentation.

YOU CANT HAVE EVLT IF YOU ARE:

• Pregnant or breast feeding.
• Planning to travel long distance within a month of treatment.