Radiofrequency Ablation (VNUS Closure)

In patients with varicose veins due to valve failure in the long or short saphenous veins, the VNUS Closure procedure may be used. This is a new minimally invasive technique performed in similar fashion to laser ablation but using an alternative energy form to close the vein.

How does it work?

Under ultrasound guidance, the VNUS Closure catheter is introduced into the saphenous vein through a small skin puncture usually under local anaesthetic. The catheter is carefully positioned close to the top end of the vein to be treated and further local anaesthetic is injected around the vein. The catheter is then heated to collapse the vein. Once the full length of the vein has been treated the catheter is removed and the skin puncture is closed with a steristrip (sticky strip). No stitches are necessary.

By treating the main superficial vein trunk the prominent varicose veins often shrink greatly as the pressure within them is reduced. This also usually relieves symptoms. In some cases it is also appropriate to either remove the bulging surface veins by small hooks (phlebectonies) or treat them by subsequent sclerotherapy (injection) as an out patient.

After the procedure

Your leg is bandaged with a firm elastic bandage for 24 hours followed by an elastic stocking for 2 weeks. You are able to walk immediately after the procedure and usually leave hospital an hour or two after the treatment. Simple pain killers such as ibuprofen (or paracetamol) are usually all that are necessary. Return to work is usually possible within a few days but depends on the type of work you do. Exercise in the form of walking is very good for the circulation after such treatment.

Are there any risks?

Some bruising is to be expected along the treated vein and occasionally phlebitis can occur (inflammation of the occluded vein). This is treated with anti-inflammatory agents such as ibuprofen. As with all varicose vein treatments there is a slight risk of deep vein thrombosis but when the VNUS Closure is performed under local anaesthetic this risk is significantly lower than for conventional surgery. Rarely numb patches on the skin may result from heating of adjacent skin nerves but these usually recover. Unfortunately there is always a risk of recurrence of varicose veins after any treatment. VNUS Closure is a relatively new technique but the evidence available at present suggests the recurrence risks are at least comparable to those after conventional surgery but with a quicker recovery, less pain and virtually no scarring.

Is there any follow up?

You will normally be seen about a month after your treatment for a routine check. If the bulging varicose vein were not treated by additional phlebotomies at the time of VNUS Closure, any that have not been adequately shrunk can be treated by simple scleotherapy (injections).