Radiofrequency-induced thermotherapy (RFITT) is a minimally invasive radio wave procedure for the treatment of varicose veins. In the RFITT procedure, the affected vein is closed using a probe that generates an alternating current through the vein wall. This generates a temperature of between 80-100 degrees.
Surgeons usually remove abnormally dilated veins (varicose veins and spider veins) using skin incisions. This is the oldest and still successfully used treatment method.
Since the end of the last millennium, however, there has also been a minimally invasive and gentler treatment method without skin incisions. Doctors close pathologically dilated veins from the inside. This includes radiofrequency-induced thermotherapy (RFITT).
An important area of application for radiofrequency-induced thermotherapy is the treatment of varicose veins. However, the RFITT method is also used in the following areas:
The RFITT method is particularly popular for vein problems because no surgical removal of the vein is necessary.
Radio-frequency induced thermotherapy (RFITT) is a minimally invasive thermal procedure to permanently close varicose veins @ Svitlana /AdobeStock
How does RFITT work?
In the RFITT method, doctors insert a probe tip the size of a pinhead into the varicose vein. This is done by means of a puncture (puncture). Doctors then use high-frequency electricity (radiofrequency radiation) to stimulate the vein wall from the inside. The heat effect (80-100 degrees Celsius) causes the vein walls to stick together. They then close up.
RFITT is an endoluminal (internally acting) thermal (targeted application of heat) procedure for the treatment of varicose veins. The aim of the therapy is to permanently close the diseased veins.
A special probe emits controlled radiofrequency energy into the walls of the affected vein. The heat damages the vessel, resulting in the vein being obliterated. This is followed by complete closure of the varicose vein. After closure, the former vein turns into connective tissue. The body then breaks it down.
Damage to nearby structures is possible and is one of the undesirable side effects. For this reason, doctors inject a physiological saline solution with local anesthetics around the varicose veins. In this way, they try to protect the healthy connective tissue.
This creates a protective layer around the vein. The infiltrated saline solution also has a cooling effect. Treatment with the addition of local anesthetics is less painful for the patient.
A modern procedure that reduces the undesirable side effects is the Celon method from Olympus. A permanent resistance measurement within the tissue regulates and controls the delivery of current. This results in less frequent burns.
Vein treatment using the RFITT method is performed on an outpatient basis. First, the doctor and patient take a detailed medical history.
The doctors then perform an ultrasound scan so that they can assess the situation precisely. Before the actual treatment with radiofrequency-induced thermotherapy, the doctor informs the patient in detail about the risks and procedure.
On the day of the procedure, the doctors perform another ultrasound imaging of the veins. The patient stands and the doctors mark the pathologically dilated veins. The Celon method is performed under local anesthesia and takes around an hour in total.
After the local anaesthetic, doctors puncture the vein, make a tiny opening and insert the electrode. This sends a targeted radio frequency current into the tissue. The emitted current heats the area and causes circumscribed clotting (coagulation).
During the procedure, doctors measure the resistance to ensure that the current is delivered. During therapy, continuous measurement ensures that the application time, energy intensity and position are optimal.
An acoustic impedance signal ensures that surrounding tissue is spared during the procedure. An alarm sounds if inaccuracies are imminent.
During the course of the treatment, the treated vein is thermally obliterated and contracts until it is completely closed. The cell fluid evaporates and the vein is closed. At the end of the procedure, doctors close the puncture incision using wound glue or a small suture.
After the treatment, patients are given a tight compression bandage to ensure blood can move without clotting.
Radiofrequency-induced thermotherapy is a minimally invasive procedure. Compared to surgical methods, it offers numerous advantages.
These include
The patient-friendly alternative to classic varicose vein operations such as stripping can also be associated with disadvantages. These include, for example,temporary discoloration in the treatment area. This discoloration remains until the patient's body has broken down the sclerosed veins.
In addition, not all statutory health insurance companies cover the costs of the therapy, which can mean financial disadvantages.
Doctors have been using RFITT procedures since the 1980s. The Celon method in particular is already a standard thermal therapy procedure today. Compared to other methods, the procedure is associated with few risks and side effects in the context of spider veins and varicose veins. Nevertheless, as with any other procedure, there are risks of complications in individual cases with this minimally invasive procedure, such as
The above complications are extremely unlikely with the Celon method. More common side effects, however, are dizziness, itching or nausea due to overreactions to the anesthetic. Temporary sensory disturbances or temporary pain are also among the more common side effects.
As RFITT is a minimally invasive procedure, no special follow-up treatment is required. The ability to work is generally retained and mobility of the leg is possible.
Wearing a compression stocking is still recommended. Experience has shown that this leads to a subjective reduction in discomfort if it is worn during the day for the first 1-2 weeks. Sometimes painkillers such as Diclofenac (Voltaren®) are required to relieve pain and swelling.
After RFITT treatment, doctors use an alcohol-based solution to remove any remaining spider veins on the leg. This procedure is also known as sclerotherapy. It is also possible on an outpatient basis and without anesthesia.
Sclerotherapy means "gluing" the varicose veins @ rh2010 /AdobeStock
The risk of varicose veins persisting or reappearing after RFITT treatment is 10 to 30 percent. This may be because the treatment was not successful and the vein walls have not adhered. Repeated treatment with radiofrequency therapy may then be necessary. Surgical treatment is also possible.
Even after successful treatment, new varicose veins can form (recurrence) if other veins in the leg expand. This is particularly common in pregnant women and family history also plays an important role.
Experts recommend that susceptible people wear medical compression stockings. This can prevent recurrences, especially in stressful situations such as long flights or car journeys.
The Leading Medicine Guide's quality assurance is ensured by the following acceptance prerequisites.
