Is Radiofrequency Closure Treatment of Varicose Veins Painless?

Is Radiofrequency Closure Treatment of Varicose Veins Painless?

Varicose Vein Treatment with Little or No Pain – Really!

Radiofrequency Closure of varicose veins is virtually painless for most people.

However, pain sensitivity to varicose vein treatments varies tremendously from person to person. What one person perceives as extremely painful – another person doesn’t feel at all.

Take it from a vein doctor who has been specializing in varicose veins for over thirty years.  Pain perception is quite subjective.  The awareness of a painful stimulus is greatly influenced by apprehension, fear and anxiety.

Vein surgery for varicose veins used to be done exclusively in the hospital. General anesthesia was required which meant you had to go to sleep for the operation. Surgery consisted of varicose vein stripping which was very painful for everyone who had this procedure.

Nowadays, varicose vein procedures are done exclusively in a doctor’s office. In the doctor’s office, local anesthesia is all that is required. That means that only a few numbing injections are used to take away the pain during your vein procedure.

How to Get Rid of Your Varicose Veins Without Pain

It’s pretty close to being painless!

Since radiofrequency closure of varicose veins was approved in March 1999, the technology has improved and evolved. At the same time, laser was used in a similar way to close or ablate the saphenous vein. Both techniques have evolved dramatically since those early days.

Saphenous vein ablation is usually required when varicose veins are treated. Both radiofrequency and laser are equally effective in closing down the saphenous vein.

The major difference that I have found recently is that radiofrequency ablation or closure rarely requires pain medicine after the procedure. This was not the case with many laser procedures that I performed in the past for varicose vein removal.

Studies have been done in the past to verify my impression. Patients usually require pain medicine after a laser saphenous vein ablation within the first ten days of having their procedure done.

Pain Differences Treating Varicose Veins : Laser Vs. Radiofrequency

When pain scores were adjusted for the number of pain tablets taken there were small differences noted in scientific studies.

However, from personal experience, none of my patients who had radiofrequency required narcotic pills after their vein treatment. That is not true for laser.

When large veins are closed with laser, more heat energy is required. This extra heat with laser is transmitted to the surrounding tissues and nerves.

With laser, the higher heat requirement to close the vein or seal it off translates into the need for stronger pain medication.

What Types of Radiofrequency Closures Are Currently Available?

The name, Radiofrequency Closure, is not technically the current treatment du jour for varicose veins. That was the old name for the first generation saphenous vein ablation procedure to be FDA approved – even before laser.

The currently used radiofrequency device for varicose veins is called ClosureFAST. It is continually improving and evolving. Four radiofrequency systems are currently available commercially to close saphenous veins.

In this country, the most commonly used by far is Medtronic’s Venefit ClosureFAST.  Most scientific studies comparing radiofrequency closure with laser has been described using this ClosureFast system.

In Europe, the RFiTT device by Olympus is used but requires that the operator pull out the catheter at the correct speed much like with a laser procedure. This introduces another variable in achieving optimum results. Two other radiofrequency systems for treating varicose veins, EVRF and VeinCLEAR are used much less frequently.

The following is a RFiTT procedure video demonstrating the other method of using radiofrequency to ablate or seal saphenous veins. It is not used in the United States.

What is Chronic Venous Insufficiency Treated With Radiofrequency?

Leg venous insufficiency is common in adults. Initially it begins as a cosmetic bother. In its early stages, there are usually no symptoms.

Left untreated, chronic venous insufficiency gets worse over time. It can be quite debilitating in the later stages.

Chronic venous insufficiency is always progressive. That means it does not improve no matter what you do to try to stop it from getting worse. Exercise does not help.

There are valves inside of your veins which normally prevent the blood from going in the wrong direction. Failure of the valves to close properly is genetic.

The incorrect flow of blood towards your feet instead of toward your heart causes the blood to pool in the legs. As a result, the veins bulge and enlarge. In time, they can become tortuous.

It is manifested by the visual appearance of varicose veins in most cases. Varicose veins are the bulging and ropey veins that are seen on the surface of the skin.

Traditionally, saphenous stripping surgery has been used to remove the great or small saphenous veins.

Although often initially successful, the pain involved after the procedure often resulted in a delay in return to normal activities.

That is not the case when radiofrequency ablation of the saphenous vein is performed. Most patients can return to work the next day.

Relief of symptoms is immediate.

The treated veins shrink and are absorbed by your body.

Radiofrequency treatment of varicose veins has success rates of more than 95 per cent.

Scientific Studies Proving Radiofrequency Effectiveness  in Treating Varicose Veins

Proof of radio frequency’s safety and effectiveness is well established in the scientific literature. A study by Dr. Artwohl verified that it is less painful than alternatives. Clinical studies have corroborated this.

It is comparatively priced and covered by insurance companies.

In the Recovery trial results comparing radiofrequency to laser, venous clinical severity scores showed up to a four times faster improvement in patients’ quality of life based on a quality of life questionnaire. They also found less bruising and fewer complications.

Five-year results from the European study of multiple centers on radiofrequency segmental thermal ablation for incompetent great saphenous veins has been published. Dr. Thomas Proebstile published these results in 2015. This research has proven its durability and effectiveness.

In his words, “It is a clinical and anatomic success.”


Radiofrequency of varicose veins is virtually painless compared to laser.

Laser treatment of varicose veins requires much more heat (2200 degrees Fahrenheit for laser vs. 250 degrees Fahrenheit for radiofrequency.)

What do you think would hurt more – 250 degrees or 2200 degrees?

From our experience, radiofrequency treated varicose vein patients – compared to laser – require less pain medication (usually none at all) and do not require narcotics after treatment.

As the only inspected and accredited vein center in Pittsburgh, we never resterilize our radiofrequency catheters as some unaccredited vein centers do.

Dr. Happel has the longest experience in Pittsburgh treating varicose veins. No doctor has been specializing in veins longer in our city. He is a board certified vascular surgeon. His credentials, experience, and qualifications say it all.

Call us at 724-969-0600 to learn about this amazing, minimally invasive varicose vein technique which has withstood the test of time.

About The Author

Dr. John Happel

Dr. John Happel has been in practice as a surgeon since 1986 in the Pittsburgh region. He specializes in vascular surgery and has subspecialized in the treatment of varicose and spider veins since 1999. Dr. Happel is board certified in vascular surgery and recertified in vascular surgery in 2012. He was chosen in 1985 to fulfill the position for the vascular surgical fellowship at the world renowned Mayo Clinic.