What is the Technology Behind Radiofrequency Ablation?

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elderly vein care

In the second of this three-part series about radiofrequency ablation (RFA), board-certified vascular surgeon Christopher Bulger, MD, FACS, explains the science behind this minimally invasive procedure. Dr. Bulger is the lead physician at Center for Vein Restoration’s South Windsor and Glastonbury, CT locations.

Dr. Bulger recollects that the ultrasound-guided technique used today as an out-patient was mainly used in the past in the hospital by anesthesiologists to place a central line near the heart. This same ultrasound technology is now widely used to assist in the precise placement of the radiofrequency catheter during the RFA procedure.

Dr. Bulger describes the radiofrequency catheter as a thin relatively flexible wire that travels through a thin hollow tube or sheath, like an IV. This catheter carries within it the radiofrequency wire that delivers the heat-based treatment. This long thin catheter has a resistive coil at the end from where the energy is delivered. Using ultrasound guidance, the physician uses a small needle to get into the vein. Once the needle is in the vein, the physician holds the position in the vein with a small micropuncture wire and exchanges the needle for the sheath and catheter.

Typically, the radiofrequency catheter travels the entire length of the vein. This is because once the vein becomes abnormal (or, refluxes), the blood is no longer traveling in the correct direction back to the heart.

The patient doesn’t feel the wire because there are no nerves inside the vein.

How Does Radiofrequency Ablation Treat Vein Disease?

Dr. Bulger explains that treatment of leg veins fifteen to twenty years ago meant removing the vein, also known as vein stripping. Removal is a much more involved in-patient surgical procedure requiring general anesthesia and extended time off to recover. Now, with the advent of targeted techniques such as RFA, the vein is closed down during an out-patient procedure.

While RFA is well-tolerated, the necessary anesthetic medication, called lidocaine, can be painful “for a minute or two” due to the volume and acidity of the medicine. Dr. Bulger compares it to getting an anesthetic injected during a dental procedure. The purpose of the lidocaine is three-fold; to numb the area, to compress the vein wall (called the endothelium) so that it fits snuggly around and “touches” the radio radiofrequency catheter, and finally act as a buffer to the surrounding tissue.

Once turned on, the heat from the catheter destroys the vein lining. The vein will then shrivel and become a scar that doesn’t need to be removed.

How to Choose the Right Vein Doctor

Dr. Bulger emphasizes that RFA is an important tool that is neither new nor experimental and has been used for years with exceptional results. Dr. Bulger calls RFA “a significant breakthrough in patient care.” He advises that a person seeking this treatment be certain that their physician has extensive experience with RFA technology. With experience comes the knowledge of what to do and not to do should the procedure not go exactly as planned.

Customized Treatment Plans

Center for Vein Restoration physicians develops customized treatment plans based on patient needs, goals, and lifestyle. Using a variety of advanced treatment options, CVR, the nation’s number one provider of vein care, has the technology that’s right for you. To find a CVR physician near you, call 1-800-FIX-LEGS or visit centerforvein.com.


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