Radiofrequency Ablation (RFA) for Varicose Veins — Tel Aviv

What Is Radiofrequency Ablation?

RFA is a minimally invasive technique for permanently closing refluxing saphenous veins without open surgery. A thin catheter is inserted through a small skin puncture into the diseased vein under real-time ultrasound guidance. Radiofrequency energy heats the vein wall to approximately 120°C, causing the collagen in the wall to contract and the vein to seal shut permanently. Over the following weeks, the body absorbs the closed vein and reroutes blood flow through healthy veins.

The result: immediate reduction in venous pressure, improvement in symptoms (heaviness, swelling, pain), and gradual disappearance of visible varicosities over 3–6 months.

Step by Step: What Happens on Procedure Day

1. Pre-procedure duplex ultrasound — A standing duplex ultrasound maps the target vein immediately before treatment, giving a real-time anatomical guide.
2. Catheter insertion — Under a small local anesthetic, a thin needle introduces the RFA catheter into the vein and advances it to the treatment start point under ultrasound visualization.
3. Tumescent anesthesia — A dilute local anesthetic solution is injected along the full length of the vein. This feels like multiple small stings and is the most uncomfortable part of the procedure — but it takes effect within minutes.
4. Radiofrequency ablation — The catheter delivers controlled RF energy as it is slowly withdrawn. The vein wall contracts and seals. Most patients feel nothing at this stage.
5. Compression and walking — A compression bandage is applied. You walk around the clinic for 20 minutes and then leave.

Total procedure time: 60–90 minutes. No hospitalization. Patients arrive walking and leave walking.

Ideal Candidates for RFA

RFA vs Traditional Stripping Surgery

Before RFA, the standard treatment for varicose veins was open surgical stripping — physically removing the saphenous vein through incisions along the leg, under general anesthesia. This required hospitalization, weeks of recovery, significant post-operative pain, and visible scarring.

RFA replaces open surgery with an outpatient procedure lasting one hour — no incisions, no general anesthesia, no hospital stay, return to activity within 24–48 hours. Multiple randomized controlled trials demonstrate higher success rates, fewer complications, less pain, and significantly greater patient satisfaction with RFA compared to open surgical stripping.

RFA vs VenaSeal — Which to Choose?

Both procedures achieve similar success rates (~95% anatomical closure at one year). The key difference is procedure experience:

• RFA requires tumescent anesthesia (multiple injections along the vein). It is performed at a private hospital (Assuta / Herzliya) and requires private health insurance.
• VenaSeal requires only a single puncture-site local anesthetic — no tumescent injections, no compression stockings post-procedure, immediate return to full activity. Higher cost. Better suited for patients with needle anxiety, those on anticoagulants, or specific anatomical situations.

At your consultation, Dr. Aronhime reviews your duplex findings and explains which approach best matches your anatomy and preferences.

Treatment Cost

RFA is performed at a private hospital (Assuta / Herzliya Medical Center) and requires private health insurance. The treatment cost is determined by your insurance coverage — verify with your insurer before booking. Initial consultation including duplex ultrasound: ₪1,300.

Frequently Asked Questions — RFA

Does RFA hurt?

The tumescent anesthesia injections feel like multiple small stings along the leg. Once the anesthetic takes effect — usually within minutes — the ablation itself is painless. Most patients rate the experience as tolerable and say they would do it again without hesitation.

How long does RFA take?

60–90 minutes including preparation, tumescent anesthesia, and the ablation itself. You then walk around the clinic for 20 minutes before leaving.

Can I go back to work the next day?

Desk work: yes, usually within 24–48 hours. Jobs requiring prolonged standing may need 3–5 days. No extended sick leave is required.

What is the success rate of RFA?

Clinical studies report 95–98% anatomical closure at one year (J Vasc Surg Venous Lymphat Disord, 2019 consensus guidelines). Most patients report significant symptom improvement within 2–4 weeks of treatment, with continued improvement over 3–6 months as varicosities are absorbed.

Will varicose veins come back after RFA?

The treated vein is permanently closed and cannot return. Because there is a genetic component to venous disease, new varicose veins may develop over years in other veins — but not in the treated one. Compression stockings and regular exercise help slow progression.

Is RFA covered by Israeli health insurance?

RFA is performed at a private hospital and requires private health insurance. Contact your insurance provider with your duplex ultrasound findings to confirm coverage before your procedure. Our team can assist.

What is the difference between RFA and VenaSeal?

RFA uses heat (radiofrequency energy) and requires tumescent anesthesia along the vein. VenaSeal uses medical adhesive and requires only a single local anesthetic injection. Success rates are comparable; the choice depends on patient preference, anatomy, and whether kupat holim coverage is a priority.

How much does RFA cost?

RFA is performed at a private hospital (Assuta / Herzliya). Cost is determined by your private health insurance — verify coverage with your insurer. Initial consultation including duplex ultrasound: ₪1,300.

Book your consultation: 073-3744040
Contact Israel Vein Center | All Treatments | EVLA via Tofes 17 | EVLA via Tofes 17 | Varicose Veins Information

Treatment Comparison

References

1. Almeida JI, et al. Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux (RECOVERY study). J Vasc Interv Radiol, 2009.
2. Rasmussen LH, et al. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg, 2011. PubMed
3. Gloviczki P, et al. The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins. J Vasc Surg Venous Lymphat Disord, 2023–2024.