Radio-frequency and Laser Treatment of Veins

Endovascular laser therapy (EVLT) and Radio-frequency ablation (RFA) are relatively new techniques that uses heat to destroy the superficial veins from the inside. They are performed in clinic with local anaesthetic using needles. A small cut is made below the knee and a catheter inserted into the vein up to groin. Then a number of injections is made along the thigh to numb it. The machine heats and destroys the vein. Afterwards you need to wear stocking for one to two weeks. The procedures are performed as day cases and you will be able to go home soon afterwards.

The advantages are that it is performed under local anaesthetic and lower risks of bleeding, infection and pain. Generally patients are able to return to work in two to three days. However large varicose veins below the knee may still need surgical treatment with small operation at later stage. The risks of blood clots and nerve injury exist as per surgery.

The main difference between RFA and EVLT is in RFA a radio-frequency is used to heat up the vein while in EVLT a laser is used. The current literature suggests no significant difference between RFA and EVLT results. Long term both give good results; however like all varicose vein intervention there is a risk of reoccurrence.

What to do before the procedure?

What will happen during the treatment?

An ultrasound scan is performed on the leg to identify the varicose veins and locations. A small catheter is inserted usually below the knee and a wire passed up the vein. The position of the wire is located using the ultrasound to check it is in the correct position. Local anaesthetic is the injected along the thigh up to groin to numb the skin so you won't feel the rest of the procedure. The probe is the inserted over the wire and the machine is turned on. This heat treats the vein and destroys the varicose vein. Due to the local anaesthetic you should not feel any pain. If there is discomfort then more local anaesthetic can be given.

What to expect and do after the procedure?

What are the potential complications?

Next: Sclerotherapy for treatment of varicose veins.