Radiofrequency ablation varicose veins

Radiofrequency thermal energy is delivered directly to the vessel wall, causing protein denaturation, collagenous contraction, and immediate closure of the vessel.

In contrast to laser therapy, the Radiofrequency catheter actually comes into contact with the lumen walls.

An introducer sheath is inserted into the proposed vein of treatment (again usually the GSV).

A special Radiofrequency ablation catheter is passed through the sheath and along the vein until the active tip is at the SFJ just distal to the subterminal valve.

Just like the endovenous laser treatment, with the Radiofrequency,  tumescent local anesthetic is injected.

Metal fingers at the tip of the Radiofrequency catheter are deployed until they make contact with the vessel endothelium.

Radiofrequency energy is delivered, both in and around the vessel to be treated.

Thermal sensors record the temperature within the vessel and deliver just enough energy to ensure endothelial ablation. The Radiofrequency catheter is withdrawn a short distance, and the process is repeated all along the length of the vein to be treated.

Subramonia and Lees found that, compared with conventional high ligation and stripping, radiofrequency ablation of great saphenous varicose veins took longer to perform, but patients returned to their normal activities significantly earlier and had significantly less postoperative pain.