Radiofrequency ablation (RFA) has become a valued weapon in the phlebologist's armoury. It offers ease of use and reproducibility with good outcomes. However, as with all interventions, complications arise. In this review we examine the complications inherent with RFA and their relative risk, with their avoidance measures if available. Overall, we find that RFA offers a very safe procedure with rare severe complications.
LimCS, GohelMS, ShepherdAC, DaviesAH. Secondary care treatment of patients with varicose veins in National Health Service England: at least how it appeared on a National Health Service website.Phlebology2010; 25: 184–9
RasmussenLH, LawaetzM, BjoernL, VennitsB, BlemingsA, EklöfB. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins.Br J Surg2011; 98: 1079–87
4.
LaneTRA, PandeyVA, DaviesAH. Superficial venous disease treatment – is there still a role for open surgery in 2011?Acta Chir Belg2011; 111: 125–9
5.
ShepherdAC, GohelMS, BrownLC, MetcalfeMJ, HamishM, DaviesAH. Randomized clinical trial of VNUS ClosureFAST radiofrequency ablation versus laser for varicose veins.Br J Surg2010; 97: 810–8
6.
CarradiceD, MekakoAI, MazariEAK, SamuelN, HatfieldJ, ChetterIC. Randomized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous varicose veins.Br J Surg2011; 98: 501–10
7.
NesbittC, EifellR, CoyneP, BadriH, BhattacharyaV, StansbyG. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices.Cochrane Database Syst Rev (Online)2011(10): 1–66
8.
GoldmanMP. Closure of the greater saphenous vein with endoluminal radiofrequency thermal heating of the vein wall in combination with ambulatory phlebectomy: preliminary six-month follow-up.Dermatol Surg2000; 26: 452–6
9.
ProebstleTM, VagoB, AlmJ, GöckeritzO, LebardC, PichotO. Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation: first clinical experience.J Vasc Surg2008; 47: 151–6
10.
BoonR, AkkersdijkGJM, NioD. Percutaneus treatment of varicose veins with bipolar radiofrequency ablation.Eur J Radiol2010; 75: 43–7
11.
DoDV, KelleyLC. Tumescent anesthesia: evolution and current uses.Adv Dermatol2007; 23: 33–46
12.
GoodeSD, ChowdhuryA, CrockettM. Laser and radiofrequency ablation study (LARA study): a randomized study comparing radiofrequency ablation and endovenous laser ablation (810 nm).Eur J Vasc Endovasc Surg2010; 40: 246–53
13.
RolandL, DietzekAM. Radiofrequency ablation of the great saphenous vein performed in the office: tips for better patient convenience and comfort and how to perform it in less than an hour.Perspect Vasc Surg Endovasc Ther2007; 19: 309–14
14.
GandhiA, FroghiF, ShepherdAC. A study of patient satisfaction following endothermal ablation for varicose veins.Vasc Endovascular Surg2010; 44: 274–8
15.
LurieF, CretonD, EklöfB. Prospective randomized study of endovenous radiofrequency obliteration (closure) versus ligation and vein stripping (EVOLVeS): two-year follow-up.Eur J Vasc Endovasc Surg2005; 29: 67–73
16.
SubramoniaS, LeesT. Randomized clinical trial of radiofrequency ablation or conventional high ligation and stripping for great saphenous varicose veins.Br J Surg2010; 97: 328–36
17.
Di NisioM, WichersFM, MiddeldorpS. Treatment for superficial thrombophlebitis of the leg.Cochrane Database Syst Rev(Online)2007(2): CD004982
18.
KabnickL, OmbrellinoM, AgisH, MortizM. Endovenous heat induced thrombus (EHIT) at the superficial-deep venous junction: a new post-treatment clinical entity, classification and potential. In: American Venous Forum 18th Annual Meeting, American Venous Forum, 2006
19.
MozesG, KalraM, CarmoM, SwensonL, GloviczkiP. Extension of saphenous thrombus into the femoral vein: a potential complication of new endovenous ablation techniques.J Vasc Surg2005; 41: 130–5
20.
HaqqaniOP, VasiliuC, O'DonnellTF, IafratiMD. Great saphenous vein patency and endovenous heat-induced thrombosis after endovenous thermal ablation with modified catheter tip positioning.J Vasc Surg2011; 54: 10S–17S
21.
LawrencePF, ChandraA, WuM. Classification of proximal endovenous closure levels and treatment algorithm.J Vasc Surg2010; 52: 388–93
22.
MarshP, PriceBA, HoldstockJM, HarrisonC, WhiteleyMS. Deep vein thrombosis (DVT) after venous thermoablation techniques: rates of endovenous heat-induced thrombosis (EHIT) and classical DVT after radiofrequency and endovenous laser ablation in a single centre.Eur J Vasc Endovasc Surg2010; 40: 521–7
23.
ProebstleTM, AimJ, GöckeritzO., Group ECFCS. Three-year European follow-up of endovenous radiofrequency-powered segmental thermal ablation of the great saphenous vein with or without treatment of calf varicosities.J Vasc Surg2011; 54: 146–52
24.
van den BosR, ArendsL, KockaertM, NeumannM, NijstenT. Endovenous therapies of lower extremity varicosities: a meta-analysis.J Vasc Surg2009; 49: 230–9
25.
MerchantRF, PichotO, GroupCS. Long-term outcomes of endovenous radiofrequency obliteration of saphenous reflux as a treatment for superficial venous insufficiency.J Vasc Surg2005; 42: 502–9; discussion 509
26.
HankeCW, BernsteinG, BullockS. Safety of tumescent liposuction in 15,336 patients. National survey results.Dermatol Surg1995; 21: 459–62
27.
CiechanowiczS, PatilV. Lipid emulsion for local anesthetic systemic toxicity.Anesthesiol Res Pract2012; 2012: 131784
28.
AlmeidaJI, KaufmanJ, GöckeritzO. Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY study).J Vasc Interv Radiol2009; 20: 752–9
29.
MarkidesGA, SubarD, Al-KhaffafH. Litigation claims in vascular surgery in the United Kingdom's NHS.Eur J Vasc Endovasc Surg2008; 36: 452–7
30.
LeopardiD, HogganBL, FitridgeRA, WoodruffPWH, MaddernGJ. Systematic review of treatments for varicose veins.Ann Vasc Surg2009; 23: 264–76
31.
DoganciS, YildirimV, DemirkilicU. Does puncture site affect the rate of nerve injuries following endovenous laser ablation of the small saphenous veins?Eur J Vasc Endovasc Surg2011; 41: 400–5
32.
PerrinMR, GuexJJ, RuckleyCV. Recurrent varices after surgery (REVAS), a consensus document. REVAS Group.Cardiovasc Surg2000; 8: 233–45
33.
CarradiceD, MekakoAI, HatfieldJ, ChetterIC. Randomized clinical trial of concomitant or sequential phlebectomy after endovenous laser therapy for varicose veins.Br J Surg2009; 96: 369–75
34.
FischerR, ChandlerJG, StengerD, PuhanMA, De MaeseneerMG, SchimmelpfennigL. Patient characteristics and physician-determined variables affecting saphenofemoral reflux recurrence after ligation and stripping of the great saphenous vein.J Vasc Surg2006; 43: 81–7
35.
Van GroenendaelL, Van Der VlietJ. Treatment of recurrent varicose veins of the great saphenous vein by conventional surgery and endovenous laser ablation.J Vasc Surg2009; 50: 1106–13
36.
ShepherdAC, GohelMS, LimCS, HamishM, DaviesAH. The treatment of varicose veins: an investigation of patient preferences and expectations.Phlebology2010; 25: 54–65
37.
LohrJ, KulwickiA. Radiofrequency ablation: evolution of a treatment.Semin Vasc Surg2010; 23: 90–100
38.
PeräläJ, RautioT, BiancariF. Radiofrequency endovenous obliteration versus stripping of the long saphenous vein in the management of primary varicose veins: three-year outcome of a randomized study.Ann Vasc Surg2005; 19: 669–72
39.
HinchliffeRJ, UbhiJ, BeechA, EllisonJ, BraithwaiteBD. A prospective randomized controlled trial of VNUS closure versus surgery for the treatment of recurrent long saphenous varicose veins.Eur J Vasc Endovasc Surg2006; 31: 212–8
