RADIOFREQUENCY ABLATION

Radiofrequency Ablation (RFA) is one of the 2 Medicare Approved “Minimally Invasive” techniques for the treatment of major veins, previously treated by “stripping” surgery.

As with Endovenous Laser Ablation (EVLA), RFA relies on thermal (heat based) damage to the vein, that leads to immediate closure of the vein. Once the vein is treated by RF Ablation, it will gradually undergo complete absorption by the body and disappear over time.

The published success of Radiofrequency Ablation treatment is between 95-98%, with far fewer complications than surgery. Due to the lower temperatures utilised to heat the affected vein, post RFA discomfort is much less than that experienced with Endovenous Laser Ablation. In our experience, a significantly less number of patients complain of discomfort and pain following treatment with RF Ablation.

TECHNIQUE

With ultrasound guidance, an RFA fibre is placed into the abnormal vein through a tiny incision. The vein is then numbed with local anaesthetic, and the RFA fibre is activated. The RFA Fibre has a unique design and consists of a 7 cm length active tip, through which the RFA energy is released. The vein wall is heated along this 7 cm length section of the RFA Fibre. Generally speaking, the fibre is activated for 20 to 40 seconds for every 7 cm length of vein, making the whole procedure quick and easy to perform. The release of Radiofrequency Energy from the tip of the Fibre, produces a thermal reaction in the vein wall along the treated section, resulting in collapse and sclerosis of the vein wall with minimal discomfort afterwards.

CARE AFTER SURGERY

  • Your stocking should be worn continuously for the next 7 days.  These can be removed and you can shower.  The stocking should be replaced immediately after showering and it should be worn day and night.
  • After your 7 days you should wear your stocking only during the daytime for the next three weeks.
  • You should expect mild to moderate discomfort in the first few days.  Unless contra-indicated, you should take the prescribed Panadol for the first 48-72 hours. Ibuprofen can be used for additional discomfort.  After this you can use panadol as required.
  • You should begin normal activities the next day. Going for a 30 minute walk each day is required as a minimum. Swimming without the stocking is also acceptable. Avoid any strenuous exercise and running for at least 2 weeks after the treatment.
  • It is normal for some swelling, bruising, lumpiness and tenderness to be associated with the healing process.  This can sometimes be mistaken for infection.  This appearance relates to trapped blood within the treated veins.
  • Occasionally this trapped blood will need to be removed by needle aspiration, which can occur during your follow-up visit at 6 weeks.  Do not hesitate in contacting the rooms for an earlier review if there are any concerns.
  • It is better to avoid any prolonged travel of greater than 4-5 hours duration for the next 6 weeks.  If you need to travel during this time, please discuss the appropriate ways of preventing deep venous thrombosis (DVT).

While surgery on varicose veins is considered to be safe and effective, there are a few possible side effects. If you have any concerns or want to know more please contact us.

Scars 
Scars usually fade, but sometimes they are permanent and unsightly. Healing and fading of scars can take a few months. Patients should not get the legs sunburnt during this time as this can make the scars worse.

Discolouration
Brown discolouring can occur over some of the treated area. Although the colour usually fades, sometimes it is permanent and unsightly.

Soreness
Sore lumps may be due to bruises (in the space left where the veins came from) or blood clots within remaining short lengths of vein. These lumps usually shrink and lose their soreness over a few weeks.

Numbness
Some nerves run close to surface veins. They may be injured during surgery, particularly when a stripping operation is performed between the knee and ankle. This may cause some numbness,“pins and needles” or, occasionally, pain. Recovery from this can be very slow, up to two years in some people, and in rare cases it is permanent.

Loss of long saphenous veins 
Removal of the long saphenous vein can prevent its future use as a heart artery bypass. Therefore it is usually not removed in patients who have diabetes, high blood pressure, heart disease or artery disease in the legs or arms. However, a badly diseased long saphenous vein is of no use for a heart artery bypass.

Side effects of anaesthesia 
Modern anaesthesia is safe with few risks, however some people do have a serious reaction to anaesthetic drugs. If you have ever had a reaction to an anaesthetic drug, tell your surgeon.

Fortunately, serious problems after surgery are uncommon.
Infection may occur in wounds, especially in patients who have ulcers.
Blood clots can occur in the deep veins.