Radiofrequency ablation of veins of the lower limb reviews

Advantages and disadvantages

The undoubted advantage of wave or radiofrequency ablation of the veins of the lower extremities is that it can be an alternative to surgery, after which many scars remain. Considering that the procedure is performed relatively quickly, it has other advantages:

It takes place without anesthesia, but only with local anesthesia.
The operation is low-traumatic and well tolerated by patients at all stages.
There is no need to place sutures at venous access sites.
Possibility of using the method in the later stages of varicose veins.
Minimum number of disease relapses.
The accuracy of the method allows it to be carried out even on small veins.
The most studied among all minimally invasive methods of treating varicose veins.
Power and frequency are determined automatically thanks to the built-in computer.
Fast recovery and minimal hospital stay.

Radiofrequency obliteration should be prescribed in cases of metabolic disorders in the skin and muscles
. Despite such a large number of positive aspects in using the method, it is not ideal. The disadvantages of the method are:

High cost of the procedure. The relatively high price is associated with the use of modern equipment.
The need to protect the tissue around the vein on which the intervention is performed. Such measures are taken to prevent energy from leaving the vein and damaging muscles and tissues.
For anesthesia, adrenaline is used, which is contraindicated for people with cardiovascular pathology.
During the intervention, vessels may be destroyed with the formation of small subcutaneous hematomas.
In the postoperative period, ultraviolet rays should be avoided.
The need to use venous compression after surgery.

Symptoms of varicose veins of the lower extremities

Radiofrequency ablation of lower extremity veins is the most common treatment for varicose veins in the United States and Canada.

The disadvantages of the drug include its contraindications, namely:

Pregnancy, early postpartum period and breastfeeding.
Deep vein thrombosis of the legs.
Thrombophlebitis of the subcutaneous and deep veins.
Obesity of the third and fourth degree.
The patient's inability to perform active movements.
Arterial thromboembolism.
Bacterial lesions of the skin of the legs with obvious intoxication syndrome.
Acute ischemia and edema of the lower extremities.

If any of the above conditions are present, radiofrequency ablation of the veins of the lower extremities should be delayed.

The introduction of sclerosant in foam form causes a pronounced spasm of the vein, which makes it possible to influence the vascular endothelium with a minimal amount of the drug.

Consequences of the procedure

RFO of the veins of the lower extremities received positive reviews. However, such an intervention is still an operation, and for this reason the possibility of complications cannot be excluded. Thanks to the improvement of the process, the human factor is minimized, due to this, negative consequences of the procedure occur extremely rarely.

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Only in exceptional cases do I diagnose pain, loss of sensitivity in the operated leg, extensive hematomas, or perforation of a blood vessel in a patient after surgery.

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The severe consequences of radiofrequency ablation also should not be discounted, as with other types of therapy for varicose veins. The risk of a problem is 12%, usually vascular thrombosis.

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The most dangerous consequence of any type of intervention is pulmonary embolism; very often it will cause death. In this case, the likelihood of a violation is reduced to zero. For the most part:

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the result of the operation is satisfactory;
there is no discomfort;
the prognosis is favorable.

Doctors do not rule out a recurrence of varicose veins; the reasons may be excessive load on the inguinal veins or poor-quality radiofrequency ablation.

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The risk of re-development of the pathological condition is similar to that of other types of surgery. But at the same time, this technique has undeniable advantages, first of all, an excellent cosmetic effect. After treatment, there are no scars or scars left on the legs, which is especially important for women.

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Experts will talk about radiofrequency vein ablation in the video in this article.

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Radiofrequency ablation of veins is a modern method of surgical treatment. With its help, vascular surgeons quickly, without injury, efficiently cope with the most complex changes in the circulatory system.

The operation is performed for various stages of varicose veins. It is especially indicated in severe cases of the disease, when serious pathologies in nutrition and tissue innervation are diagnosed.

It is recommended to treat the initial stages of varicose veins with medications, massage, and other conservative methods. Deep lesions of the veins of the lower extremities require exclusively surgical intervention.

Radiofrequency ablation is performed as post-thrombotic therapy. In some cases, none of the treatment measures helps eliminate the disease; only removal of the affected areas and blood clots is provided. Then wave destruction will become an option:

Ablation of the veins of the lower extremities will be a salvation for severe venous insufficiency. This pathological disorder is practiced along with a course of medications. With an integrated approach, positive dynamics are achieved and the functionality of the affected legs returns.

What's in this article:

Advantages and disadvantages, contraindications
Mechanism of the operation
Preparation for the procedure
Recovery and prevention
Consequences of the procedure

Recovery period

The minimally invasive procedure allows the patient to return to an active daily routine within 20-30 days. However, even after this period has expired, the patient needs to adhere to a diet and undergo therapeutic exercises. If postoperative recommendations are not followed, there is a risk of relapse of the disease, as well as hardening of the vessel walls in other areas. For a quick regenerative process you will need:

drink 2.5 l-3.5 l of water and a very small amount of salt per day;
wear anti-embolic underwear every day, remove therapeutic hosiery only at night while sleeping;
for twenty days do not take a hot bath, do not go to baths and saunas;
after six days, start physical therapy classes;
Take daily walks of at least 40-50 minutes.

Important!

After radiofrequency obliteration, observation by a leading vascular surgeon is necessary, who after seven days should prescribe angioscanning of the extremities using ultrasound tomography.

Progress

After reviewing the data on the patient’s condition, a decision is made on the need for the procedure. If the patient has no contraindications, the operation can begin. To perform radiofrequency ablation, it is necessary to prepare the following instruments:

Examination of the patient and assessment of the condition at the time of the operation.

disposable scalpels and catheters;
dressing material, cotton wool and gauze wipes;
anesthetic solution (Lidocaine or Novocaine);
syringes for local anesthesia;
disinfectants and antiseptic solutions;
a device that will emit radio frequency waves;
compression garments, which are worn immediately after surgery.

The operation is quick and painless. The action takes place in several stages.

Operation stages:

Immobilization of the required veins and their marking.
Filling the paravenous space with an anesthetic to relieve pain and protect nearby tissues from high-frequency waves.
Making small incisions at the site where the disposable catheter will pass.
Venipuncture and passage of a catheter with a guide into the cavity of a varicose vein.
Delivery of pulses with a frequency determined by the built-in computer, and obliteration of varicose veins.
Decateterization and treatment of the minimally invasive intervention site with antiseptics.
After completing the manipulation, it is necessary to compress the vessel that has succumbed to the effects of the waves.
At the end of the operation, the patient must wear compression garments and stay in them for 1-2 days.
The last condition is the need to walk a distance of up to two kilometers.

The operation is quick and painless. The action takes place in several stages.

Obliteration of varicose veins occurs due to the fact that under the influence of waves the inner wall of the vein is destroyed and aseptic inflammation is formed. Along with destruction, blood clots form, which prevent the restoration of blood flow in this vein.

Compression of blood vessels after blockage plays an important role. If compression is applied correctly, the likelihood of relapse is reduced.

After the operation, the patient does not stay in the hospital, but he should follow certain rules for a quick recovery.

Radiofrequency Induced Thermotherapy - RFITT

During the RFITT procedure (Celon method, manufacturer - Olympus medical systems, Japan), the electrodes of the intravenous catheter operate on the principle of a bipolar coagulator. The generator produces high-frequency alternating current, which is transmitted to the electrodes of the intravenous catheter. Due to the microwave thermal effect created by these electrodes, local heating and thermal damage to the wall of the varicose vein occurs.

The RFITT procedure has a less pronounced thermal effect on surrounding tissues than the Venefit procedure. This is the only thermal method that (according to the manufacturer) allows the refusal of tumescent anesthesia when the varicose vein is located intrafascially and spinal anesthesia or anesthesia is used. Considering that the modern approach to intravascular methods of treating varicose veins involves the abandonment of anesthesia and spinal anesthesia, this advantage seems doubtful to us.

Indications and contraindications for radiofrequency obliteration techniques are, in general, similar to those for endovenous laser coagulation; first of all, the smooth course of the target vein trunk. RFO can be used to treat varicose veins of both the great and small saphenous veins, as well as their tributaries. Along with EVLT, radiofrequency obliteration is a good choice in the presence of venous trophic disorders in the lower leg area.

Indications for use

If we talk about cases in which this treatment method is used, the basis for performing RFO is a doctor’s referral after conducting the appropriate diagnosis. In general, this method of treatment is used for the following pathological processes:

Varicose veins – radiofrequency obliteration can be performed regardless of the type and location of the affected vessels, as well as at any stage of the disease. Of course, in most cases, surgery is justified in the later stages of development of varicose veins, when there is a real threat to human health or conservative methods of combating pathology do not bring tangible results. In most cases, in the later stages of development of varicose veins, RF surgery and other surgical methods are the only way to treat the patient.
Venous insufficiency is another reason for performing RFO; it is noteworthy that venous insufficiency often occurs as a complication after varicose veins or in the later stages of pathology development. In this case, radiofrequency obliteration is combined with the use of special drugs.
Post-thrombotic therapy – there are often cases when, after the formation of a blood clot, it is not possible to restore the full functioning of a particular vessel. In such cases, surgical removal of the latter is required, and the RFO method is one of the best in achieving such goals.

Radiologists

Patient reviews

Many thanks to Margarita Fedorovna for a successful and painless operation! From the first day on my feet, everything healed very quickly! Thank you! Further

I would like to express my deep gratitude to Igor Vladimirov for his professionalism and golden hands. This is a doctor who clearly knows his job. For more than 15 years I had terrible varicose veins and finally decided to have surgery. I didn’t regret for a second that I did it. Only 20 days have passed since the operation, and I already see a great result. Thank you very much again! Further

I would like to thank Margarita Fedorovna Ryakhovskaya for her professionalism and attentive attitude towards patients!

Ryakhovskaya Margarita Fedorovna is a doctor from God.

The operation was performed in early January 2020 by Margarita Fedorovna Ryakhovskaya. From the bottom of my heart I want to thank her for her hands, professionalism and ability to prepare a person for surgery! If it weren’t for Margarita Fedorovna, I probably would have been walking around with varicose veins for a long time. In a word - a DOCTOR from God. THANK YOU. Further

Advantages and disadvantages of the method

Radiofrequency ablation of veins has the following advantages:

Time of operation. Depending on the degree of damage to the blood vessel, it lasts on average 15-35 minutes.
Less traumatic. It is not necessary to make deep and long cuts on the skin for penetration. There are no necrosis or open wounds. Allows you to shorten the recovery process and return the patient to a normal lifestyle.
Does not cause severe pain.
General anesthesia is not required.
The method gives positive results, which is confirmed by numerous reviews from doctors and patients.
No hospital stay or bed rest is required.
After the operation there are no scars, scars, or hematomas.
It is possible to use the method in conjunction with sclerotherapy and drug therapy.
Minimal risk of negative results.

RFO has a uniquely designed catheter design. Enclosed in a small thermal capsule, which allows the energy of the radio frequency field to be converted into thermal energy not at the tissue level in the body, but directly inside the waveguide (catheter) itself. This is the main difference from endovasal laser obliteration. This minor improvement allows for a controlled and dosed effect of heat on the vein wall.

Radiofrequency ablation (obliteration) for varicose veins

The disadvantages include:

High price. The patient does not always have the financial ability to undergo it.
Sunbathing and visiting bath complexes are not allowed.
You are required to wear compression garments.

Recovery and prevention

After the manipulation, the patient must understand that full restoration of functionality takes up to one month. During this time, the load of transporting oxygen molecules and nutrients is taken on by the nearby leg vessels.

For a good regeneration process, it is necessary to wear compression garments. Depending on the location of the pathological process, the patient is recommended to wear therapeutic socks, socks, stockings or tights.

To select the correct underwear, individual measurements are taken; the product must properly compress the leg and support it without causing discomfort. In some cases, in order to eliminate symptoms after surgery, the phlebologist advises not to remove compression products even at night.

Latest information: Thrombophlebitis of the lower extremities: treatment with folk remedies

Full training and sports activities begin 7-10 days after the body has fully recovered. Nowadays they no longer adhere to bed rest; on the contrary, short-term ones are indicated:

Walking at a moderate pace will be an excellent prevention of swelling and complications of surgery. Reviews from patients confirm this.

But you should refrain from visiting the sauna, solarium and bathhouse if you have varicose veins. The patient needs to drink plenty of clean water and reduce table salt intake. Such measures will prevent blood thickening and swelling.

Restorative measures are supplemented by taking venotonics, using ointments against varicose veins, gymnastic exercises, and a contrast shower.

All methods help restore adequate blood circulation.

Procedure process

Preparation

No special preparatory procedures are required. The patient undergoes an ultrasound examination to confirm the correctness of the chosen therapeutic tactics. A general examination is also required:

blood analysis;
testing for sexually transmitted diseases;
consultation with the attending physician to exclude contraindications.

Immediately before radiofrequency vein obliteration surgery, it is necessary to remove hair from the limb on which the operation will be performed. The patient can, under the guidance of a doctor, choose a bandage or compression stocking that is suitable for him.

Radiofrequency vein obliteration

A puncture is made in the vein, then a radiofrequency conductor is inserted there. When the doctor, under ultrasound control, is convinced that the guidewire is installed correctly, local anesthesia (“water featherbed”) is applied around the vessel. It anesthetizes the process and delimits the vein from surrounding tissues.

Next, the high radio frequency generator is started, transmitting waves to the working element of the catheter. One inclusion allows you to treat 3-7 cm of the affected organ. The generator is turned off, and the catheter is passed along the lumen of the vessel to the next section, the procedure is repeated until the entire vein has been treated.

This process is completed by removing the catheter and applying a bandage at the puncture site. A compression stocking is placed on the limb.

Rehabilitation period

It is important that the patient immediately after surgery and limb compression walks a certain distance at a brisk pace, spending approximately 40 minutes walking. Compression garments will need to be worn for 1-2 weeks.

For the first few days, active physical exercise is not recommended: aerobics, using an exercise bike, gymnastics. The patient needs to devote about an hour to walking every day and reduce the time spent sitting and standing. It is not recommended to take a bath with hot water or visit a sauna.

Compression garments will need to be worn for 1-2 weeks. For the first few days, active physical exercise is not recommended: aerobics, using an exercise bike, gymnastics. The patient needs to devote about an hour to walking every day and reduce the time spent sitting and standing. Taking a bath with hot water and visiting a sauna is not recommended.

In general, a person after RFO can lead a full life without any special restrictions.

The doctor should conduct an examination after 2-3 days and perform an ultrasound scan. Other follow-up visits to a specialist are also possible.

PRICE LIST

Name	price, rub.
The cost of operations includes: surgery, anesthesia, a repeat appointment with a phlebologist with ultrasound diagnostics a month after the operation.
Radiofrequency obliteration (ablation) of the veins of one lower limb (RFO) of increased complexity	69700
Radiofrequency obliteration (ablation) of the veins of one lower limb (RFO)	63000
Radiofrequency obliteration (ablation) of the veins of one lower limb (RFO) of increased complexity + miniphlebectomy	88200
Radiofrequency obliteration (ablation) of the veins of one lower limb (RFO) + miniphlebectomy	89900

All price

Method of endovenous laser obliteration

Laser coagulation of veins is a method of treating varicose veins, similar to the RFO method

Currently, treatment of vascular diseases occurs using both conservative methods, for example, phlebectomy, which has been used for a hundred years, and sclerotherapy, based on the introduction of drugs into the diseased vessel.

But the main competitor of radiofrequency obliteration is a very similar technique of laser coagulation (EVLO), which dates back to 1999.

The principle of operation is similar to RFO. A very thin fiber is inserted into the diseased vessel through a puncture until the atrophied vein connects with the healthy vessel. A laser beam with the wavelength necessary to boil the blood and destroy the collagen protein of the vessel walls is passed through the optical fiber. After thermal exposure to the laser, the venous walls are welded together, and the blood flows into other healthy vessels.

Currently, laser beams with a wavelength of 1470 nm are used, absorbed by the aqueous medium, to quickly boil it. The vein is heated to a temperature of 85°C, sufficient to connect its walls. Surgery is not performed on large-diameter veins.

Anesthesia is absolutely similar to RFO - a gasket of anesthetic is formed around the vessel.

Which of the two methods - RFO or EVLO should the patient choose?

It is difficult to give preference to any method. Operations performed using these methods show equal effectiveness and safety compared to phlebectomy. In both cases, the effect on the vein occurs using thermoobliteration. Only the principles of heat transfer are different - using a laser beam or a wave electrode.

The advantage of radiofrequency obliteration is that the device does not require adjustment for a specific patient and the operation can be performed by a doctor who does not have much experience (error due to the human factor is excluded). This procedure is used to treat the small and large saphenous vein and large diameter vessels (1.5 cm or more).

The advantages of laser coagulation include the cheaper cost of the operation and the possibility of performing the procedure on thin veins, thanks to new technologies using very thin optical fibers.

Every year, the latest developments by scientists regarding the treatment of vascular diseases appear. Just as there are no standard ways to get rid of varicose veins of varying degrees, there is no specific “best” technique.

Phlebectomy has many side effects, and recovery takes much longer. RFO and laser coagulation are not available to everyone. When choosing intravascular exposure, RFO, for some indications, is superior to the laser method of surgical intervention.

Very important: After vascular surgery using any of the techniques, it is necessary to be observed by a doctor, followed by an ultrasound scan

Pros and cons of ablation

The advantages of the procedure are high efficiency, a short period of time, the absence of cosmetic defects (scars, cicatrices), and the wound heals quickly after the operation. Another advantage is that after the treatment session you can immediately move as usual.

Radiofrequency obliteration of leg veins has the following advantages:

short deadlines;
no need to stay in hospital;
high efficiency of treatment even of deep veins;
exclusion of wounds and scars as during conventional surgery;
no need to administer sclerosants.

After such an intervention, thrombosis may develop.

risk of thrombosis;
burns;
development of inguinal reflux;
the appearance of blisters on the skin;
high cost of the procedure.

Possible complications after obliteration of varicose veins:

pain syndrome that goes away within a few days;
bruises and swelling;
vascular network disappearing within 14 days;
thrombophlebitis.

The doctor is obliged to obtain complete information about the patient’s life, including the periods of the menstrual cycle and the use of hormonal contraceptives. Before prescribing RFO for varicose veins, the patient undergoes a number of the following examinations:

Blood and urine tests for the presence of invisible inflammation.
Ultrasound or Dopplerography. They allow you to identify the diseased area, its length and the diameter of the vessel.
Visual inspection. Determines the best puncture site and the absence of skin problems in the obliteration area.

Before surgery, the patient must shave his legs.

On the eve of the procedure, you should get rid of unwanted hair with a razor. This will help treat the skin better and avoid infection. 1 day before RFO, you should take 1 tablet of Cardiomagnyl to prevent thrombosis. To undergo the procedure, you must wear loose clothing made from natural fabrics.

The term "ablation" refers to a procedure for evaporating material. The basis for the described technique was the use of radio frequency energy with an indicator from 300 to 750 kHz. The source of such energy is usually an electric generator.

The radiofrequency current enters the vein through a special catheter, previously inserted through a medical needle.

Next, the catheter slowly moves along the vessel, reaching a height that is equal in length to the segment to be excised. After this, the generator is activated, the supplied current heats the walls of the vein to 120 degrees.

The positive aspects are:

no pain;
fast operation;
absence of scars on the skin;
short rehabilitation period;
almost 100% absence of relapses.

For any minimally invasive procedure performed on diseased veins, RFA has certain disadvantages:

the likelihood of thrombosis;
skin burn;
inguinal reflux;
the appearance of blisters.

Complications

After surgical therapy, the following complications may occur:

redness, thickening of the skin;
nagging pain (lasts up to 14 days);
increase in body temperature up to 38 degrees;
peeling of the skin;
during active physical activity, throbbing pain;
swelling;
bruises at the injection site;
darkening of the epidermis for a short period of time.

Possible complications disappear within 16 days and do not cause any health hazard.

Indications and contraindications for

Of course, the main indication for the RFO procedure is the recommendation of a phlebologist. If none of the methods of conservative treatment of varicose veins has produced results, the doctor will carefully study the patient’s medical history, recommend hardware and laboratory diagnostic procedures, assess the presence or absence of chronic diseases (which may be a contraindication to surgery), and only after that can give a referral for RFO.

For what diseases is the procedure indicated:

Varicose veins at various stages of the disease. Radiofrequency obliteration of veins shows itself to be most effective in the later stages of pathology development. In the advanced stage of the disease, there is a high risk of developing thrombophlebitis and the formation of trophic ulcers, therefore, to avoid such complications, immediate surgery is recommended. If the initial stage of varicose veins can be treated with medications, massage, and wearing compression garments, then the late stage of the pathology can only be treated with surgical intervention.
Postthrombotic therapy. If, after all the therapeutic measures taken, it is not possible to save the damaged vessel, its removal is required. The RFO method is the most suitable in this case, and is also painless and minimally invasive, that is, safe.
Venous insufficiency. If varicose veins lead to such a pathology, then the operation is combined with the use of medications. This approach provides rapid restoration of the functionality of the legs and rapid achievement of results.

Unfortunately, in some cases, a procedure such as radiofrequency obliteration is prohibited, and to treat varicose veins, you will need to resort to an alternative method of intervention.

Contraindications for RFO:

The period of pregnancy and breastfeeding. It is during these periods that doctors recommend not performing surgical interventions, even minimally invasive ones. Such a prohibition is justified by the possible development of an unexpected reaction to the components of painkillers, thickening of the blood and other anatomical changes that occur in the body in pregnant and lactating women. Doctors' advice is to wait until the end of the breastfeeding period and then perform the operation. During pregnancy and lactation, it will be enough to take medications (with the doctor's permission), wear compression stockings and massage.
Atherosclerosis of venous walls. Pathology can negatively affect the condition of the veins during the recovery period and lead to the development of complications, so doctors do not recommend exposing yourself to unnecessary risks.
Thrombosis of the veins of the lower extremities - superficial or deep. Before performing RFO, it is recommended to stabilize the situation and eliminate the symptoms of the disease.
Inflammatory processes of bacterial or viral etiology, especially against the background of suppuration, which occur on the skin in the area of surgical manipulation. During the intervention, a bacterial infection can enter the lumen of the vessel, which is fraught with serious complications.
Other pathologies of the body for which wearing compression stockings is contraindicated.

Before giving permission to conduct radiofrequency obliteration, the doctor must carefully examine the patient’s medical history, in particular the tendency to allergic reactions, the presence or absence of diabetes mellitus and problems with the hematopoietic system.

Consequences of the procedure

Only in exceptional cases do I diagnose pain, loss of sensitivity in the operated leg, extensive hematomas, or perforation of a blood vessel in a patient after surgery.

The severe consequences of radiofrequency ablation also should not be discounted, as with other types of therapy for varicose veins. The risk of a problem is 12%, usually vascular thrombosis.

The most dangerous consequence of any type of intervention is pulmonary embolism; very often it will cause death. In this case, the likelihood of a violation is reduced to zero. For the most part:

the result of the operation is satisfactory;
there is no discomfort;
the prognosis is favorable.

Doctors do not rule out a recurrence of varicose veins; the reasons may be excessive load on the inguinal veins or poor-quality radiofrequency ablation.

Experts will talk about radiofrequency vein ablation in the video in this article.

Advantages of the technique

Radiofrequency ablation of varicose veins is a treatment method that has already won the trust of many doctors and has helped a huge number of patients get rid of the problem. The technique is relatively new, but is already widely used if the necessary equipment is available. It is more preferable for patients, especially in old age, since it is easier to tolerate and in most cases proceeds without complications.

Doctors highlight several advantages of this method of treatment:

no need for hospitalization - recovery easily takes place at home (outpatient) conditions;
carried out under local anesthesia - this method of pain relief is less dangerous than general anesthesia;
no skin incisions, hence no postoperative scars;
effectiveness even in the presence of complications in the form of trophic ulcers;
the possibility of carrying out at any time of the year, including in the summer - you don’t have to worry about purulent complications during the rehabilitation period, as well as long-term wearing of compression garments.

REFERENCE! The only disadvantage of radiofrequency ablation is the cost of the procedure. Many patients still prefer traditional surgical treatment, despite all its disadvantages.

Contraindications

All methods of treating varicose veins have contraindications for use, radiofrequency ablation of blood vessels is no exception. Medical specialists include contraindications:

Pregnancy, breastfeeding.
Atherosclerotic changes in the walls of blood vessels. They affect the recovery process, complications may occur.
Thrombosis in the superficial venous system, thrombosis of the deep venous system. Before the operation, the situation should be stabilized and the disease eliminated.
Infectious processes on the skin of a purulent-inflammatory, viral nature. During surgical treatment, infection may enter the lumen of the blood vessel.
Diseases that do not allow wearing compression products.
Excess body weight.

Ablation has many advantages compared to other methods of restoring blood circulation.

Stages of the operation

During RFO of the veins of the lower extremities, two medical workers will be next to the patient. The operation is carried out in several stages:

Anesthesia of affected vessels. Despite the fact that RFO is a virtually painless procedure and does not cause discomfort to the patient, doctors still prefer to perform external anesthesia. Anesthesia is necessary so that the patient feels relaxed and does not flinch during the puncture of the vein. Otherwise, the vessel will be damaged, and the accuracy of insertion of the catheter into the vein will be impaired. Therefore, before starting the procedure, sprays, creams and other anesthetics are applied to the skin.
Skin puncture to insert a radiofrequency conductor into the cavity of the saphenous vein.
Creation of a “water feather bed” - an anesthetic substance is injected around the vein to numb the vessel locally and limit it from surrounding tissue.
Turning on a radiofrequency generator that transmits radio waves to the working part of the catheter. Under the influence of the waveguide, the walls of the vein heat up, then collapse, and they are soldered. The advantage of the procedure is that the doctor does not need to manually enter any settings into the device - the device independently selects the power of action on the venous wall, as well as the time required for effective soldering. Data is transmitted by special sensors built into the catheter and determine the effectiveness of the procedure. This stage is carried out under the continuous supervision of a doctor using ultrasound, which allows you to monitor any nuances. With one turn on of the device, it is possible to treat from 3 to 7 centimeters of the vein, after which the guide moves until the affected vessel is completely treated. After such radio wave treatment, the affected vein ceases to participate in the circulatory system, and its functions are performed by healthy blood vessels.
Upon completion of radiofrequency obliteration of the veins of the lower extremities, the puncture site is covered with a special adhesive bandage, and a compression stocking is put on the leg.

A few hours after the procedure, the doctor can send the patient home, after making sure that he is in good health and giving recommendations on how to behave correctly during the recovery period.

How is the operation performed?

Initially, local anesthesia is given. The procedure is considered painless and does not cause discomfort to the patient. But during a puncture of a blood vessel, the patient may tremble and disrupt the accuracy of insertion of the catheter, injuring the venous wall. Then a puncture is made and a device is inserted, and a disposable thermal capsule is inserted through it. The capsule emits radiofrequency waves that affect the affected areas of the venous system and the connective tissue of the walls of the blood vessel. Minimally invasive surgical treatment is performed by a doctor under the control of an ultrasound machine. This allows the catheter to be positioned correctly. The power and temperature indicators of the radio wave energy supply are adjusted by the device automatically, without the participation of a doctor. Each section of the vein is exposed to hardware for 20 seconds. The device tracks time automatically. Sections of the circulatory system are subjected to radiofrequency occlusion sequentially. When the doctor removes the catheter, the final stage of occlusion of the blood vessel begins. Upon completion of the operation, an adhesive plaster is applied to the puncture site and compression stockings are put on.

For such a pathological disorder, surgery is used together with medications.

Recovery period

Radiofrequency vein obliteration is a minimally invasive procedure and does not require any serious measures during the recovery period.

Basic recommendations:

Proper compression of the leg is of great importance in the postoperative period. Wearing compression garments should be constant, how long you need to wear stockings - the doctor will recommend based on the history of a particular patient. In most cases, 24-hour wearing of stockings is recommended for the first 2–3 days, then the patient is allowed to remove them at night and put them on only during the daytime.
During the entire recovery period, it is prohibited to take a hot bath, only showers are allowed. There is no need to remove the stocking during hygiene procedures; it is better to protect it with waterproof underwear. The skin of the legs can be wiped with antibacterial wipes or lotion; puncture and injection sites should not be touched.
At the end of wearing compression stockings and completing the recovery period, you need to visit your doctor for an initial examination and, on his recommendation, undergo an ultrasound.

Doctors also advise that after RFO, you should walk daily for at least 1 hour, but limit other physical activities - do not engage in aerobics, do not lift weights, and avoid strength sports. You cannot visit the sauna and solarium for 40–50 days.

Preparing for surgery

Despite the fact that the operation is minimally invasive, phlebologists recommend adhering to some recommendations before starting the intervention:

Three days before the scheduled procedure, the patient should stop using ointments and creams with heparin. It is also not recommended to use gels and non-steroidal anti-inflammatory drugs.
Before the operation, the patient must purchase elastic bandages or compression hosiery to consolidate the effect of radiofrequency ablation. Compression is carried out immediately after the procedure and continues for some time.
On the day of manipulation and the day before it, you should not go to saunas and steam baths.
At work, it is necessary to inform about the upcoming absence, since loads on the legs can be given after 2-3 days.

Microthermocoagulation of spider veins

In addition to general preparation, before the operation it is necessary to conduct medical preparation, which includes the following steps:

Carrying out ultrasound diagnostics of veins on which intervention is planned.
Blood sampling for general clinical and specific laboratory examinations. The attending physician is interested in the activated platelet index and their number. Blood coagulation rate according to Duke and Lee-White.
Examination of the patient and assessment of the condition at the time of the operation.

After thorough preparation in compliance with all necessary rules, you can begin the procedure.

Stages of the radiofrequency ablation procedure

The entire procedure is carried out under the control of duplex ultrasound scanning. With the patient in a standing position, a varicose vein is marked.

After disinfection treatment, a puncture of the lower segment of the vein damaged by varicose veins is performed and a catheter is inserted, with the help of which radiofrequency ablation (RFA) of the veins of the lower extremities will be performed. The price for the procedure increases slightly due to the use of a disposable catheter.

Stage 1 of Radiofrequency ablation – insertion of a radiofrequency catheter into a varicose vein

The catheter is advanced along the vein to the upper segment, that is, to the point where the vein flows into the deep venous system. At the end of the catheter there is a 7 cm long radio frequency element, which will transmit high frequency waves.

Stage 2 of Radiofrequency ablation – tumescent anesthesia

Next, local anesthesia is administered. In this case, almost complete pain relief is achieved. The demarcation of the vein from nearby tissues is carried out thanks to tumescent anesthesia - a “water cushion”.

Stage 3 of Radiofrequency ablation – treatment of varicose veins with radiofrequency waves

Next, the generator is started, and the given area is processed with radio frequency waves for 20 seconds. Radiofrequency ablation (RFA) of the lower limb occurs in stages. Using the markings on the radiofrequency catheter, the RFA technician withdraws the catheter 7 cm and restarts the generator. It is worth noting that the device operates in automatic mode, independently adjusting the level of exposure power depending on the temperature inside the vein. The duration of exposure is also determined automatically. In this case, there is no possibility of influence of the “human factor”, since the doctor only monitors the progress of the catheter through the vein and does not determine the settings. Everything happens automatically.

Stage 4 of Radiofrequency ablation – removal of the radiofrequency catheter

This is how radiofrequency ablation (RFA) of the veins of the lower extremities is performed. Videos demonstrating the progress of this operation prove the comparative simplicity of this method. The entire operation lasts about 30-40 minutes. At the end of the procedure, the patient immediately puts on compression stockings. Over the course of several weeks, a connective tissue cord forms at the site of the problem vein.

In almost all cases, RFA is complemented by Varadi miniphlebectomy or sclerotherapy of tributary (superficial) veins. The question of using one or another additional treatment method is decided by the specialist who will perform radiofrequency ablation (RFA). The price is largely determined by the amount of radiofrequency exposure and the choice of additional method to achieve maximum effectiveness. External changes occur immediately after radiofrequency ablation (RFA) of the veins of the lower extremities is performed. Photos before and after the procedure clearly show the effectiveness of this treatment method.

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What are the disadvantages of radiofrequency vein obliteration (ablation)

In our opinion, the disadvantages of the RFO method are:

The implementation of a feedback mechanism using a thermocouple, designed to eliminate as much as possible the influence of the human factor on the procedure, is not implemented perfectly.
The number of vein heating cycles recommended by the manufacturer is often insufficient for adequate thermal obliteration of the vein. That is, relapses of the disease are possible.
With RFO, it is difficult to obtain vein retraction (narrowing) similar to laser coagulation, which can also cause a relapse of the disease.