Radiofrequency Ablation:
A Leading Venous Insufficiency Treatment

» Request a referral to a venous insufficiency specialist at John C. Lincoln

Performed at John C. Lincoln Hospitals on an outpatient basis in just 45 minutes, radiofrequency vein ablation is a technologically advanced, nonsurgical therapy for relieving the pain and swelling associated with chronic venous insufficiency (CVI) and varicose veins.

A much more effective alternative to laser therapy, this virtually painless, minimally invasive procedure does not require stitches or sutures. It uses high-temperature radiofrequency energy to ablate (or remove) a malfunctioning vein that causes lower-leg pain, ankle swelling and varicose veins.

Once complete, patients can resume normal activities — including work — on the same day as this procedure. What's more, this procedure is covered by most health insurance providers and Medicare.

When Radiofrequency Vein Ablation Is Recommended

Radiofrequency vein ablation is indicated when a vein called the great saphenous vein begins to fail. Located just beneath the skin, this vein has one-way valves that close when we stand, preventing gravity from pulling blood to our calves and ankles. When closed, these valves allow blood to circulate back to our hearts.

Before and after treatment for varicose veins: Following radiofrequency vein ablation at John C. Lincoln, patients can resume regular activity the next day.

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However, when these valves do not close completely, they lose the battle against gravity and allow blood to "leak" downward, causing blood to pool up in the calves, ankles and feet after we stand for prolonged periods of time. A reddish or purplish discoloration of the calves and ankles may develop. In a worst-case scenario, if the condition is not treated, skin can break down from the constant tension produced by the swelling — a related condition called venous stasis ulcers.

A leaking saphenous vein also can cause blood to back up in superficial veins that drain into the saphenous vein. Over time, these superficial veins become progressively more swollen and rope-like — easily visible varicose veins.

Think of the saphenous vein as a cracked roof shingle, and a varicose vein as a resulting water spot on the ceiling. To treat the water spot, one must first treat the source of the problem — replacing the shingle, itself. Merely painting over the water spot — treating the varicose vein, itself — does not fix the leak.

How Radiofrequency Vein Ablation Is Performed

Overall, about three hours of a patient's time are needed to perform radiofrequency vein ablation. This includes one hour for a pre-procedure patient assessment and another hour for post-procedure monitoring.

Varicose vein removal with radiofrequency ablation: The catheter is inserted into the diseased vein (far left), where it emits radiofrequency energy (center). Without using a laser, the varicose vein is heated until the vein wall is sealed shut and collapses (right), and the catheter is removed.

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Because this therapy is minimally invasive and nonsurgical, it can be performed under local anesthetic. Typically, the inner thigh is numbed with lidocaine. Some patients choose to have conscious sedation, which puts them in a light, arousable sleep. Others patients opt for valium to feel relaxed, or choose no sedation whatsoever.

A radiofrequency vein ablation procedure begins with making a tiny incision in the skin of the inner thigh, at the knee joint. This opening affords room for a microscopic probe, which is guided upward to the saphenous vein. Ultrasound images guide the probe. No radiation is used.

Once it has reached its target, the probe emits pulses of heat, generated by radiofrequency waves, which heats the vein wall to 185 Fahrenheit. This causes collagen — a protein that forms most soft tissue — in the vein wall to collapse. Surrounding tissue is not damaged. Soon after the procedure, the narrowed vein gradually becomes fibrous. The interior of the vein walls becomes sealed shut, naturally redirecting blood flow to healthy veins.

An Alternative to Laser Surgery for Varicose Veins

John C. Lincoln uses radiofrequency vein ablation instead of laser for varicose veins. Compared with the laser technique, patients who have undergone radiofrequency ablation have experienced:

• No pain afterward, compared to some pain afterward with a laser-based technique.
• No discoloration in the skin overlying the vein, compared with some discoloration and bruising overlying the vein with a laser-based technique.

Radiofrequency vein ablation is also a much faster procedure, overall, compared with a laser-based technique.