Efficacy and safety of radiofrequency ablation for lower limb varicose veins

Anushtup De, Prabal Roy, Sunil Kumar


Background: Endovenous Radiofrequency Ablation (RFA) is gradually gaining widespread acceptance as a minimally invasive modality for treatment of varicose veins (VV). The objective of this study was to evaluate the efficacy based on Venous Doppler and Venous Clinical Severity Score (VCSS) and the safety of radiofrequency ablation for varicose veins.

Methods: This is a prospective study of 58 consecutive patients who underwent Radiofrequency ablation of Varicose veins from January 2015 to January 2017 in a single unit of a Multispecialty Tertiary Care Hospital. The mean age was 44.10±13.74 years (19-75 years). A total of 78 limbs were treated in 58 patients. RFA was performed using Closure FastTM catheter according to the manufacturer’s recommendation. Treatment outcomes were estimated 15 days, 3 months, 6 months and 1 year after the procedure using Doppler scan and VCSS score.

Results: There was 100% occlusion of the treated veins with no evidence of partial/complete recanalization. However, 2 (2.56%) patients had a GSV stump length > 3cm on Doppler at 6 months, without evidence of significant reflux. Minor complications such as ecchymosis erythema, pain and induration rapidly improved over short term. One patient (1.3%) had evidence of Deep Vein thrombosis (DVT) on follow up Venous Doppler. The mean VCSS improved from mean of 7.98 preoperatively to 2.24 after 1 year (P value <0.001).

Conclusions: Radiofrequency ablation is a safe and effective procedure with minimal major complications. The minor complications were early and resolved rapidly.


Radiofrequency ablation, Varicose veins, Venous clinical severity score

Full Text:



Kaplan RM, Criqui MH, Denenberg JO et al. Quality of life in patients with chronic venous disease: San Diego population study. J Vasc Surg 2003;37:1047-53.

Malhotra SL. An epidemiological study of varicose veins in indian railroad workers from the South and North of India, with special reference to the causation and prevention of varicose veins. Int J Epid. 1972;1:177-83.

Subramonia S, Lees T. Radiofrequency ablation vs conventional surgery for varicose veins: a comparison of treatment costs in a randomized trial. Eur J Vasc Endovasc Surg. 2010;39(1):104-11.

Singh SK, Chaudhary P, Khandelwal S. Treatment of varicose veins of lower limb: a prospective randomized comparison of radiofrequency ablation and conventional surgery. Hellenic J Surg. 2014;86(6):347-54.

Proebstle TM, Vago B, Alm J. Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation: first clinical experience. J Vasc Surg. 2008;47:151-6.

Jin HY, Ohe HJ, Hwang JK. Radiofrequency ablation of varicose veins improves venous clinical severity score despite failure of complete closure of the saphenous vein after 1 year. Asian J Surg. 2017;40(1):48-54.

Giuseppe G, Silvia R, Andrea G. Endovenous radiofrequency ablation for the treatment of varicose veins: a single centre experience. World J Vasc Surg. 2018;(1):1001.

Almeida JI, Kaufman J, Göckeritz O. Radiofrequency endovenous closure FAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY study). J Vasc Interv Radiol. 2009;20(6):752-9.

Hingorani AP, Ascher E, Markevich N. Deep venous thrombosis after radiofrequency ablation of greater saphenous vein: a word of caution. J Vasc Surg. 2004;40(3):500-4..

Proebstle TM, Alm BJ, Göckeritz O. Five-year results from the prospective European multicenter cohort study on radiofrequency segmental thermal ablation for incompetent great saphenous veins. Br J Surg. 2015;102(3):212-8.

Siribumrungwong B, Noorit P, Wilasrusmee C. A systemic review and meta-analysis of randomized controlled trials comparing endovenous ablation and surgical intervention in patients with varicose vein. Eur J Vas Endovasc Surg. 2012;44:214-23.

Marsh P, Price BA, Holdstock J. Deep Vein Thrombosis (DVT) after venous thermoablation techniques: rates of endovenous heat-induced thrombosis (EHIT) and classical DVT after radiofrequency and endovenous laser ablation in a single centre. Eur J Vasc Endovasc Surg, 2010;40(4):521-7.