Radiofrequency Ablation (RFA)

Do you have bulging varicose veins that are causing you symptoms, are a source of embarrassment, or are somehow impacting your lifestyle? You don’t have to live with this problem! Varicose veins are caused by venous insufficiency, a problem that in many instances can be easily cured with a state-of-the-art treatment called radiofrequency ablation.

What is venous insufficiency?

The job of the veins in your legs is to bring the blood up towards your heart. To assure that the blood only travels up the veins, one-way valves exist which normally open as blood flows up the legs and close to prevent blood from going downhill.

If those valves in a leg vein no longer work properly, blood will go down the wrong way in the vein, causing vein branches in the leg below to become dilated. This process, which is irreversible, is known as venous insufficiency and causes varicose veins to form.

Signs and symptoms of venous insufficiency

Not all patients with venous insufficiency have symptoms. However, signs and symptoms of venous insufficiency are, in fact, common. These often include one or more of the following:

  • Bulging, twisted or ropy varicose veins
  • Aching, cramping or throbbing leg pain
  • Leg heaviness
  • Leg fatigue
  • Leg swelling
  • Darkening of the skin of the lower leg
  • Open wound on the leg (venous stasis ulcer)

Why do I have venous insufficiency (varicose veins)?

In any given patient it may be difficult to determine what caused them to develop venous insufficiency (and varicose veins). However, certain risk factors exist, including:

  • Family history
  • Jobs requiring prolonged standing or sitting in one place
  • Obesity
  • Pregnancy
  • Hormonal influences
  • Advancing age
  • Trauma
  • History of blood clots in the legs

What is RFA and how does it treat venous insufficiency?

RFA (radiofrequency ablation) is one of the most popular and effective treatments for venous insufficiency. It involves passing a tiny catheter into the affected vein and heating the vein so it seals shut. This halts the process of blood going the wrong way down the leg and cures venous insufficiency. The blood is then re-routed to normal veins in the leg.

Is RFA FDA approved?

RFA for venous insufficiency received RFA approval in 1998. As the first FDA approved thermal treatment for venous insufficiency, it has been around for a long time and has been proven to have excellent long-term results.

What other names does RFA go by?

RFA is known by a few different names, including ClosureFast, the Venefit procedure, VNUS Closure and the Closure procedure.

Do I have to be put asleep for RFA?

Absolutely not. This procedure was specifically designed to allow patients to have their venous insufficiency treated comfortably while awake. This avoids the risks and recovery from general anesthesia, allowing a quick return home after treatment.

The old-fashioned way of treating venous insufficiency was called “stripping”. That procedure was normally performed under general anesthesia due to it being much more invasive and uncomfortable than RFA.

What to expect during RFA

RFA is a simple procedure that is performed in the office with your awake. After your leg is cleansed, a tiny amount of local anesthetic is placed on the skin. A small catheter is then placed into the problematic vein under careful ultrasound guidance. A special medication, called “tumescent anesthesia”, is then placed around the vein, totally numbing the area. The vein is then heated with radiofrequency energy, causing it to close.

After the RFA is complete, the catheter is removed and a bandage is placed on your leg. You are then up on your feet and can immediately walk to your car. The procedure itself takes about a half hour to complete, is relatively painless and easy to undergo.

Does RFA hurt?

In good hands, RFA is a very comfortable procedure. The only thing you should feel is when the numbing medication is place in the skin and around the vein. By using a tiny needle, distraction techniques, and keeping you engaged with music and conversation, your provider should be able to make this an easy process for you.

What to expect after RFA

After RFA your leg will be placed in a bandage which typically goes from your foot to your thigh. The bandage will stay on your leg for 1-2 days, after which you will wear a compression stocking on your leg for a couple of weeks.

There is very little discomfort after RFA. Any pain that you may experience is typically mild and easily managed with ibuprofen (Advil or Motrin) or Tylenol. In the following weeks, you may notice a tightness or pulling sensation over the treated vein. This is part of the normal healing process and goes away as you stretch and engage in exercise.

Are there any activity restrictions after RFA?

More than likely you will be able to return to work immediately after treatment. As for other activities, you should refrain from high intensity exercise like weightlifting, running, spinning and hot yoga for a couple of weeks. It will also be best to avoid hot baths, spas and saunas during this time. After two weeks you can resume all activities, without restrictions.

Will I need any other treatments after RFA?

RFA is a procedure that treats venous insufficiency, the underlying source of varicose veins. This treatment closes off a vein under the skin surface but does not remove the bulging varicose veins visible to the naked eye.

After RFA the visible varicose veins may very well shrink in size and do occasionally disappear entirely. It is not uncommon, however, to have some residual noticeable varicose veins. These veins may require additional treatment with microphlebectomies and/or ultrasound guided foam sclerotherapy to get them to disappear.

What is the success rate of RFA?

In good hands the technical success rate of RFA is very high at greater than 99%. This means that the doctor has successfully entered the vein and treated it with RFA energy. On rare occasions additional treatment may be needed to fully close the problematic vein.

As for long-term success, somewhere between 95-98% of the time the treated vein remains closed (when the vein is observe with ultrasound 5 years after treatment). In the event that the vein is noted to be open and insufficient again, it can normally be re-treated in some fashion.


Am I a good candidate?

If you have varicose veins that bother you either physically or aesthetically, you may be a good candidate for RFA. Of course other treatment options exist, one of which may be a better choice for you. The only way to know for sure is to have a consultation with a vein expert – one who offers multiple solutions to accommodate a wide range of patients’ needs.

To learn more about RFA

Contact Beach Aesthetics at (310) 986-2906 and make an appointment with Dr. Rayman today. As one of L.A.’s top rated vein specialists, Dr. Rayman’s expertise and compassion helps his patients get the very best experience and results possible. And you deserve the best!

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