Radiofrequency Ablation


Radiofrequency (Rf) Ablation is a minimally invasive treatment for varicose veins that uses radiofrequency energy (instead of laser energy) to heat up and damage the wall inside a vein.

Radiofrequency Ablation vs Laser

There are many similarities but a number of differences between the two systems. Both systems do a very good job of ablating saphenous veins and result in far better recovery and longer-term outcomes than surgical vein stripping or sclerotherapy.

Comparing Radiofrequency with Laser


 LASERRADIOFREQUENCY
ANAESTHETICLocal tumescentLocal tumescent
HEAT1000 degrees C120 degrees C
ENTRY HOLESmall (16g IV cannula)Large (7 French introducer)
SPEEDSlow (7cm in 70 seconds)Fast (7cm in 20 seconds)
SPECIAL ROOM REQUIREMENTSYESNO
PROTECTIVE EYEWEARYESNO
$$$ CAPITAL OUTLAYYESNO (not often)
SAFE FOR BEGINNERSNOYES
VEINS TREATEDMany (expert user)
Saphenous, accessory vein
Branch veins, perforator veins
Few
Saphenous veins
Perforator (special sytlet)
Some Surgeons claim to have chosen Rf over laser because it is associated with a less painful recovery than following laser. This was certainly true in the past as older generation lower frequency laser equipment using cheaper “bare fibres” was associated with a higher level of postoperative pain. Patients should be aware that surgeons and Phlebologists using equipment older then 5yrs may be using lower frequency (< 1470 nm) laser associated with a more painful recovery. Older and cheaper “bare “ fibres are also associated with more painful recovery than modern “radial “ fibres. Most experience phlebolgists with experience of both systems prefer the great flexibility of laser over RF with ability to treat short segments, non saphenous veins and in the case of the expert user perforator veins. The entry hole with laser can be considerably smaller and less prone to bleed.
radiofrequency ablation

Success Rates Radiofrequency Ablation


The latest literature comparing the newest laser technology with Radiofrequency ablation (Dr James Lawson from The Netherlands 2018) confirms the two have identical post op recovery and laser has a higher success rate than Radiofrequency ablation. My personal belief is that surgeons often prefer Rf over laser not because of patient care concerns but for the following reasons.

  1. Easy to learn - Use of the Rf system requires far less technical skill than laser. The RF catheter is very forgiving and if the tumescent needle hits the catheter it will not damage it. Surgeons generally do not have high levels of experience with ultrasound and ultrasound guided procedure so this technology is generally "safe" in their hands. In contrast Laser fibres may break and serious consequences can occur if inexperienced users attempt to do EVLA.
  2. Speed - The ablation after tumescent anaesthesia with Rf can be more than three times faster than laser i.e. 2 minutes vs 7 minutes. This difference is of little concern for most phlebologists but for some busy Surgeons every seconds counts and this could mean being able to treat one extra patient per day.
  3. Financial – Rf companies often supply Rf generators “free” only charging for consumables. This means the surgeon that “dabbles” in endovenous ablation can avoid the high capital outlay that the dedicated phlebologist has when purchasing a laser.
  4. Room set up – Special laser safety precautions and safety eyewear are not required for Rf meaning it is easier and cheaper to set up a treatment room that uses Rf compared to one that uses laser.


The success rate of  RF treatment is reportedly slightly lower than that of endovenous laser ablation but in experienced hands there really little difference in success between the two systems. There is a slightly higher reported rate of phlebitis, hyperpigmentation and paraesthesia following Rf compared to laser. For all of the reasons above The Vein Clinic uses laser as the primary thermal endovenous ablation technique and no longer offers RF treatment.

Varicose Veins

Enlarged distorted, twisted and bulging veins that are swollen and raised above the surface of the skin.
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Varicose Vein Treatments

The Vein Clinic offers a wide range of treatments, with a focus on minimally invasive procedures.
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Venous Ulcers

Venous leg ulcers are the most severe consequence of untreated venous reflux, but fortunately, they are often preventable and treatable.
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Clinic Perth

Unit 6/28, Subiaco Square Road
Subiaco WA 6008 (Perth)

1300 00 VEIN (8346)
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