Your guide to radiofrequency ablation (RFA) treatment of varicose veins

Published by Dr Alex Vesey

Date posted — 2.10.24

What is radiofrequency ablation (RFA)?

If you’re struggling with the discomfort, swelling, or unsightly appearance of varicose veins, Radiofrequency Ablation (RFA) could be the solution you’ve been looking for. This minimally invasive procedure uses radiofrequency energy to target and close off problematic veins, providing long-lasting relief with less discomfort and downtime than traditional surgery.

In this guide, we’ll explore everything you need to know about RFA – from how it works to what you can expect during the procedure, what the recovery is, and the benefits it offers over other treatment options and the benefits some newer treatments like VenaSeal™ might have over RFA. Ultimately, there are lots of choices when it comes to treating varicose veins.

How does radiofrequency ablation (RFA) work?

Radiofrequency Ablation (RFA) is a minimally invasive medical procedure used to treat varicose veins by using radiofrequency energy to heat and close off the affected veins. It is part of a group of techniques referred to as ‘endovascular’ procedures because they involve operating inside the vein, rather than outside of it in the traditional approach. Radiofrequency ablation (RFA) involves inserting a small catheter into the vein, where radiofrequency energy is delivered, causing the vein walls to contract, collapse, and eventually be absorbed by the body.

How long has radiofrequency ablation (RFA) been used for treating varicose veins

RFA was introduced in the late 1990s and early 2000s as an alternative to more invasive surgical treatments like vein stripping. Around the same time, another option known as endovenous laser ablation (EVLA) was also developed.

Endovenous laser ablation (EVLA) employs a very similar technique by delivering heat to destroy the inside of the problematic blood vessels although it uses laser energy to deliver the heat. Both RFA and EVLA are similarly very effective, although RFA is associated with fewer side effects and is generally considered to be the superior method.

Expert Video

Dr Alex Vesey is our expert consultant vascular surgeon who heads up our varicose vein team. Listen to him explain the Radiofrequency Ablation (RFA) treatment.

What is involved in having the RFA procedure?

Before: Before the procedure, you’ll first have a consultation with a specialist vascular surgeon who will assess your varicose veins from taking a medical history, performing a thorough examination and an ultrasound scan to assess the anatomy of your veins. This helps determine the best veins to treat and ensures that RFA is the right option for you. On the day of the procedure, you’ll be asked to wear loose-fitting clothing and underwear that you don’t mind getting antiseptic on. You will be asked to sign an informed consent form before you go into the treatment room (a copy of this will be emailed to you in advance so you have plenty of time to read before you sign).

During: The procedure begins with the patient lying down on the treatment table and the affected leg is then cleaned and sterile drapes are applied. The doctor then makes a small incision near the knee or lower leg to insert a thin catheter into the problematic vein, guided by ultrasound imaging for precise placement. The doctor then injects a high volume of dilute anaesthetic – known as tumescent anaesthetic – along the length of the vein to be treated. As well as providing anaesthesia, this also helps to absorb the heat that is delivered to the vein during the procedure and reduces the chances of injuring surrounding tissues, like nerves. The catheter position is then rechecked and radiofrequency energy is delivered through the catheter, heating the vein walls and causing them to collapse and seal shut. This process is repeated along the length of the vein, effectively closing it off. The procedure typically takes about 30 to 60 minutes.

After: After the RFA procedure, a compression bandage or stocking is applied to the treated leg to help reduce swelling and promote healing. Most patients can stand up and walk immediately after the procedure, which is encouraged to help circulation. You may experience some discomfort, bruising, or swelling, but these symptoms usually subside within a few days. It’s generally recommended to avoid strenuous activities for about a week, but most people can return to their normal routines within a day or two. We will arrange to see you back in the clinic to assess the results, typically a few months after treatment since this is how long it takes for the veins to be reabsorbed by the body and for us to be able to assess the outcome.

The benefit of endovascular treatment with Radiofrequency Ablation (RFA) over traditional surgery

Endovascular treatment with Radiofrequency Ablation (RFA) offers significant benefits over traditional surgery for treating varicose veins.

One of the main advantages is its minimally invasive nature, which involves only a small incision and causes far less trauma to the surrounding tissues compared to traditional vein stripping surgery. This leads to a quicker recovery time, allowing patients to return to their normal activities, often within a day or two, as opposed to the longer downtime required after surgery. RFA also typically results in less pain, bruising, and scarring which improves patient satisfaction both during and after the procedure.

Additionally, because RFA uses radiofrequency energy to precisely target and close off the affected veins, it reduces the risk of complications such as nerve damage, which can be more common in traditional surgical approaches. Not everyone is suitable for RFA – which is why your initial consultation and ultrasound scan assessment is so important, to make sure you get the best treatment option for your particular condition.

Are there any newer, better alternatives to Radiofrequency Ablation (RFA)?

VenaSeal™ is a more recent innovative and effective option for the endovascular treatment of varicose veins, gaining FDA approval in 2015. VenaSeal™ uses a medical adhesive instead of heat to close off problematic veins.

The procedure involves inserting a small catheter into the vein and applying the adhesive, which bonds the vein walls together, causing the vein to seal shut and be gradually absorbed by the body. Compared to RFA, VenaSeal™ offers several advantages: it requires no heat or tumescent anaesthetic injections, which can reduce discomfort and eliminate the need for compression stockings after the procedure.
Additionally, VenaSeal™ has an even quicker recovery time – often allowing patients to resume normal activities almost immediately. While RFA remains a highly effective treatment with a proven track record, VenaSeal™ offers the same levels of effectiveness with less pain, inconvenience and downtime which is why it now accounts for around 50% of varicose vein treatment in the USA.

We are the first clinic in Scotland to introduce what is now considered to be the gold standard treatment for varicose veins.

Interested in Radiofrequency Ablation (RFA)?

If you’d like to find out if Radiofrequency Ablation (RFA) is the right treatment for you, the first step is to fill out our online consultation form. From there, our team will be able to arrange an initial consultation and ultrasound scan and we can work together to create a treatment plan that is tailored to your needs.

Dr Alex Vesey

Our vascular surgery service is led by Dr Alex Vesey. Alex is a highly skilled vascular surgeon with extensive experience in diagnosing and treating a wide range of vascular conditions. With a focus on minimally invasive techniques, Dr. Vesey is dedicated to providing patients with the most advanced and effective treatments for venous diseases, with a particular interest in the treatment of varicose veins.

Related Articles

General

RFA vs EVLA treatment for varicose veins

Radiofrequency ablation (RFA) and endovenous laser ablation (EVLA) are two minimally invasive treatments used to effectively treat varicose veins, but...

General

Everything you need to know about VenaSeal™ vein treatment

When it comes to treating varicose veins, VenaSeal™ has emerged as a revolutionary option that offers a minimally invasive and...

General

Exploring different treatments to get rid of varicose veins

Varicose veins are enlarged, twisted veins that often appear just under the skin, primarily in the legs and feet.

As everyone knows, the lack of protections in Scotland for patients having cosmetic procedures is something I have campaigned on for years. 

It’s an issue that I feel very passionately about and will not stop campaigning on until we have meaningful change from our government. I have written to the government many times over the years and during the recent consultation I wrote to the minister for public health, Jenni Minto, on behalf of 20 of the most experienced doctors in aesthetic practice from all across Scotland explaining why - in very clear scientific terms - she has got it wrong with her current proposals to allow beauty therapists to continue injecting medicines and administering medical devices. 

We have asked Jenni Minto to meet with us, to hear our perspective, but she continues to refuse to sit down and talk to us. In tonight’s STV news Donna has been exceptionally brave to speak on camera about the harm she has suffered as a result of a beautician, and the NHS care she has required, but sadly she is not alone. 

There are so many Donnas who have been harmed in Scotland and we hear about it every day in our clinics across the country although the majority are too scared or embarrassed to speak out publicly and the government don’t want to listen to the professionals.

 Whilst people like Donna continue to be harmed by the diabolical lack of regulation in Scotland, I will not stop campaigning. The government needs to act now to make injectable toxins and dermal fillers medic-only, bringing us in line with every other country in Europe, every state in America and every state in Australia. 

Why don’t our government believe people in Scotland deserve the same protections as all of these other countries?
In case you missed it, here’s Dr Rhona & Dr Iain’s live Q&A on all things perimenopause, menopause and HRT. Thanks to everyone who joined and asked questions. We’ll be doing more of these so keep an eye out for the next one! 

And if you’d like to know more about our menopause services, check out the link in our bio!
We're going live tonight at 7pm! Join Dr Rhona and Dr Iain (@driainmartin)  this evening on Instagram live, where they'll be discussing everything about perimenopause & menopause, including: �

Symptoms & early signs 
Treatment options, including HRT 
Myths vs facts - getting the right information 

They'll also be answering your questions live, so if there's anything you'd like to ask, leave a comment, send us a message or head to our stories. 

We hope you can join us!
The nose can be one of the most challenging parts of the face to get right. 

This lovely patient had a previous rhinoplasty, but she felt it was over done, making it too short and upturned. I used some filler to restore some height to the bridge of the nose as well as lengthen and de-rotate the tip.

She is over the moon with the result, which looks much more natural than the previous surgery. What do you think?
Happy International Women’s Day! Today, our incredible women’s health team are in the Herald talking about access to women’s health services in Scotland. You can read the full article at the link in our bio.

We carried out a survey of our patients and were blown away by the response - almost 1200 of you replied, and the message was very clear. Women don’t feel their health problems are taken seriously by the medical establishment and they are tired of being fobbed off. The Scottish Government introduced a plan to overhaul women’s health services from 2021 - 2024. Yet here we are in 2025 and our survey is saying that nothing has changed. 

We’re calling on the government to go further and faster! What’s your view?
We’ve just announced our brand new women’s health service, and the first clinic we’re introducing is our menopause service. 

Led by our consultant gynaecologist, Dr Iain Martin, our service is designed to deliver expert, evidence-based care for women navigating the menopause. 

We’ve developed our service to give you access to expert advice and support with packages that put your priorities and goals at the heart of everything. From simple menopause consultations where we assess your symptoms and, where appropriate, make recommendations on HRT prescriptions, to more advanced consultations with investigations and tests to help you optimise your health, our priority is making sure you are listened to and feel heard. 

We also know that continuity of care matters, so in addition to our menopause packages we’re delighted to announce our menopause subscription service, allowing you to have regular follow ups and ongoing care with the same specialist as your needs evolve. 

If you’d like to know more about any of our packages, check the link in our bio to visit our website, or send us a message and we’d be delighted to help.

Join us on Instagram to keep up with the latest results and expert insights from the clinic team.