Endovenous Ablation (Radiofrequency Thermal Ablation-RFA): ClosureFast™ | VNUS Closure | Venefit Procedure

Typical Treatment Benefits

  • Reduction or elimination of leg pain, achiness and fatigue caused by venous reflux and venous insufficiency translates to renewed enjoyment of activities such as walking, running and bicycling — results will vary by patient.
  • Improved healing of varicose veins, venous ulcers and skin changes related to venous reflux and venous insufficiency.
  • Your legs will look better!
RFA Therapy
VNUS YouTube Video

This YouTube video describes superficial venous reflux disease and the ClosureFast Procedure using Radiofrequency Thermal Ablation (RFA)

Basic Patient Information About This Treatment
Radiofrequency Thermal Ablation (RFA) uses radiofrequency energy to precisely and effectively treat patients suffering from venous reflux disease. In addition to seeing excellent results, the technology we use translates into less pain and bruising than many alternatives, and most of our patients find themselves ready to resume normal activity almost immediately. Typically, patients receive a local anesthetic to numb the treatment area.

What RFA Does
Via a small, narrow tube (catheter), radiofrequency energy is used to heat the diseased vein wall forcing its closure. As a result basically two things happen:
1) The blood flow gets redirected to healthier veins;
2) Symptoms of venous reflux such as varicose veins, leg pain, swelling, fatigue and even ulceration can be reduced or eliminated.

Considerations and Follow-up
After the procedure, Dr. Forman will have you wear a compression stocking for a couple of weeks, and may suggest a regimen of regular exercise. Some patients may experience minor bruising that goes away quickly. By comparison to stripping and other surgical techniques, those possible side effects are minimal. Results will vary by patient, and in some cases multiple treatments maybe needed to achieve the desired results. Dr. Forman carefully works with each patient to develop a plan best suited to their specific needs. Visit the Expectations and Results Section to see example before-and-after photos.

Tell Me More...

Radiofrequency Thermal Ablation (RFA) has been a minimally invasive alternative to traditional vein stripping surgery and laser treatments since 2008. During the procedure, diseased veins are closed off by inserting a catheter into a vein and heating the vein wall using temperature-controlled RF energy. Heating the vein wall causes collagen in the wall to shrink and the vein to close. After the vein is sealed shut, blood then naturally re-routes to healthy veins. At Performance Vein Institute of Los Alamitos, we use Medtronic's ClosureFast system (also known as VNUS Closure and Venefit Procedure).

Since valves can't be repaired, the only alternative is to re-route blood flow through healthy veins. Traditionally, this has been done by surgically removing (stripping) the troublesome vein from your leg. RFA provides a less invasive alternative to vein stripping by simply closing the problem vein instead. Once the diseased vein is closed, other healthy veins take over and empty blood from your legs.

During a stripping procedure, the surgeon makes an incision in the groin and ties off the vein, after which a stripper tool is threaded through the saphenous vein and used to pull the vein out of your leg through a second incision just above your calf.

With RFA there is no need for groin surgery. Instead, the vein remains in place and is closed using a special catheter inserted through a small puncture. This may eliminate the bruising and pain often associated with vein stripping (i.e., that may result from the tearing of side branch veins while the saphenous vein is pulled out). Vein stripping is usually performed in an operating room, under a general anesthetic, while RFA is performed on an outpatient basis, typically using local or regional anesthesia.

Three randomized trials of the ClosureFast procedure vs. vein stripping, including the most recent multi-center comparative trial, show very similar results. In the multi-center comparative trial, the ClosureFast procedure was superior to vein stripping in every statistically significant outcome. In the study, 80.5% of patients treated with the ClosureFast procedure returned to normal activities within one day, versus 46.9% of patients who underwent vein stripping. Also, ClosureFast patients returned to work 7.7 days sooner than surgical patients. Patients treated with the ClosureFast procedure had less postoperative pain, less bruising, faster recovery and fewer overall adverse events.1

Each RFA (ClosureFast) session takes approximately 30-40 minutes to complete.

Patients report feeling little, if any pain during the procedure.

When being treated on an outpatient basis in our venous suite, patients are given anesthetic that is administered locally.

Many patients can resume normal activities immediately. For a few weeks following the treatment, your doctor may recommend a regular walking regimen and suggest you refrain from very strenuous activities (heavy lifting, for example) or prolonged periods of standing.

Most patients report a noticeable improvement in their symptoms within 1-2 weeks following the procedure.

Patients report minimal to no scarring, bruising, or swelling following the ClosureFast procedure.

As with any medical intervention, potential risks and complications exist with RFA. All patients should consult their doctors to determine if their conditions present any special risks. Your physician will review potential complications of the procedure at the consultation. Potential complications can include: vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, paresthesia (numbness or tingling) and/or skin burn.

Only a physician call tell you if RFA is a viable option for your venous problems. Experience has shown that many patients with superficial venous reflux disease can be succesfully treated using RFA.

1 Lurie F, Creton D, Eklof B, Kabnick LS, Kistner RL, Pichot O, et al. Prospective randomized study of endovenous radiofrequency obliteration (Closure) versus ligation and stripping in a selected patient population (EVOLVES study). J Vasc Surg 2003;38:207-14.
2 Goldman, H. Closure of the greater saphenous vein with endo radiofrequency thermal heating of the vein wall in combination with ambulatory phlebectomy: preliminary 6-month follow-up. Dermatol Surg 2000; 26:452-456.

Link Library
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Medtronic | ClosureFast Patient Information

National Health Library | American Heart Lung and Blood Institute - Overview, FAQs and more

National Health Library | Medline Plus
Varicose Vein Introduction and Associated Links