ABSTRACT
Radiofrequency ablation (RFA) for treatment of the incompetent saphenous vein was first introduced in Europe in 1998 and approved for use in the United States by the Food and Drug Administration in 1999. Following RFA of the great saphenous vein, it has become clear that reflux at the saphenofemoral junction can be eliminated without groin dissection or ligation of second-and third-order tributary branches. The first-generation RFA catheters utilized bipolar electrodes at the tip of the catheter to apply to the vein wall an alternating electrical current at a frequency of 200–1200 kHz The endovenous RFA procedure is performed using both local anesthesia for vein access and perivenous tumescent anesthesia with or without sedation depending upon physician practice and patient anxiety. The treatment of saphenous vein reflux by RFA is less painful for patients than conventional surgery and patients recover faster. Risk of bleeding appears to be small and not clinically significant in patients undergoing RFA of the saphenous vein.
