RFA Treatment for Varicose Veins in Hyderabad (2026) | Radiofrequency Ablation Procedure, Recovery & Success Rates

Feature

RFA — Radiofrequency Ablation

Procedure Name

Radiofrequency Ablation (RFA) | Also known as: ClosureFast / VNUS Closure / RFA Thermal Ablation

Mechanism

Controlled radiofrequency heat (85–120°C) delivered via catheter — seals vein wall permanently

Surgical Incision?

❌ No — 2mm needle puncture under ultrasound guidance only

Anaesthesia

Local anaesthesia (tumescent) or Spinal anesthesia — no general anaesthesia required

Hospital Stay

Same-day discharge — day-care procedure

Procedure Duration

30–60 minutes per leg — depending on number of veins and extent of disease

Walking After?

✅ Yes — soon after procedure with compression stockings

Return to Work

1–3 days for desk work | 1–2 weeks for standing jobs

Technical Success Rate (Closure)

95–98% at 1 year | 85–90% at 5 years

Visible Scar?

None — 2mm needle mark fades within days

Compression Stockings Required?

Yes — worn for 1–2 weeks post-procedure

Suitable Vein Size

Great Saphenous Vein (GSV) and Small Saphenous Vein (SSV) | typically 5–15mm diameter

Bilateral Treatment

Both legs can be treated in a single session if clinically appropriate

Available At

Citi Vascular Hospital, KPHB Colony, Road No. 1, Hyderabad — Dr. Shaileshkumar Garge FRCR (UK)

What Happens

RFA (Radiofrequency Ablation)

Traditional Surgical Stripping

How vein is treated

Sealed FROM INSIDE using radiofrequency heat via catheter

Physically removed — incision made, vein stripped out

Access

2mm needle puncture under ultrasound

Multiple surgical incisions in leg and groin

Anaesthesia

Local (tumescent) or spinal anaesthesia only

General or spinal anaesthesia

Hospital Stay

Same day — go home within hours

Usually 1–2 days

Walking

soon after procedure

Next day typically

Recovery

1–3 days to office work

2–6 weeks for full activity

Bruising/Scarring

Minimal — compression mark only

Significant bruising and surgical scars

Stage

Phase

What Happens Inside the Vein

Result

1

Catheter Heating

RF energy at 460–500 kHz heats catheter tip to 85–120°C

Endothelial destruction within seconds

2

Collagen Contraction

Heat denatures collagen fibres in the vein wall — immediate shrinkage

Vein diameter reduces; wall thickens

3

Vein Sealing

Vein walls fuse together — lumen permanently closed, no blood can flow through

Vein sealed — occlusion confirmed on Doppler

4

Blood Rerouting

Venous blood immediately reroutes through deeper, healthy venous channels

Varicose vein pressure eliminated

5

Fibrosis (Weeks)

Treated vein progressively fibroses (scar tissue) over 4–12 weeks

Vein shrinks and becomes invisible under skin

6

Reabsorption (Months)

Body gradually reabsorbs the fibrosed vein over 6–12 months

Complete — treated vessel disappears

Clinical Profile

RFA Suitable?

Clinical Rationale

Duplex Doppler confirmed great saphenous vein (GSV) reflux

✅ Yes — first-line

RFA is the gold-standard endovenous technique for GSV incompetence

Small saphenous vein (SSV) reflux with posterior knee varicosities

✅ Yes

SSV also amenable to RFA — catheter approach adjusted to SSV anatomy

Leg pain, heaviness, swelling with confirmed venous reflux

✅ Yes

RFA eliminates the refluxing vein — venous hypertension resolved

Visible bulging varicose veins in thigh + calf

✅ Yes + Phlebectomy

RFA seals the feeding truncal vein; micro-phlebectomy removes visible clusters at same session

Venous skin changes (lipodermatosclerosis, pigmentation)

✅ Yes — urgent

Progressive skin damage without treatment — early RFA prevents venous ulcer formation

Active or healed venous ulcer

✅ Yes — priority

Underlying venous reflux must be treated for ulcer to heal and prevent recurrence

Recurrent varicose veins after prior surgery

✅ Yes

RFA can treat recurrent saphenous incompetence without re-exploration of prior surgical field

Patient wants bilateral leg treatment

✅ Yes — both legs same session possible

Both GSV or SSV ablations can be performed in one visit if appropriate anatomically

Straight saphenous vein diameter 5–15mm

✅ Yes — optimal

Optimal RFA catheter contact with vein wall requires relatively straight, appropriately-sized vessels

Vein > 15mm diameter or markedly tortuous

⚠️ Consider EVLT/VenaSeal

Very large or tortuous veins may have lower RFA closure rates — alternative technique may be preferred

Contraindication

Suitability for RFA

Alternative Approach

Active Deep Vein Thrombosis (DVT)

❌ Contraindicated

DVT must be fully treated and resolved before any vein ablation procedure

Pregnancy

❌ Contraindicated

All elective varicose vein treatment deferred until after delivery and 3 months post-partum

Severe peripheral arterial disease (ABPI < 0.5)

❌ Contraindicated

Compression stockings may worsen ischaemia — arterial disease must be assessed and treated first

Inability to walk post-procedure

❌ Not suitable

Walking is essential post-RFA to prevent DVT — bedridden patients not candidates

Very tortuous or large vein (>15mm)

⚠️ Relative

Consider EVLT (laser) or VenaSeal (cyanoacrylate glue) — better suited to tortuous anatomy

Known allergy to local anaesthetic (lidocaine)

⚠️ Assess

Alternative local anaesthetic or controlled environment management — discuss pre-procedure

Isolated cosmetic thread veins only (no truncal reflux)

❌ Not indicated

RFA treats truncal venous reflux — thread veins treated with sclerotherapy instead

When

Preparation Step

Details / Notes

1–2 Weeks Before

Duplex Doppler Ultrasound — Vein Mapping

Essential pre-procedure imaging — maps reflux, identifies which veins to treat, measures vein diameter, confirms saphenous junction anatomy

1–2 Weeks Before

Initial Consultation with Dr. Garge

Review Doppler findings, explain procedure, discuss anaesthesia, answer questions, obtain written informed consent, plan technique selection

1 Week Before

Medication Review

Blood-thinning medications (warfarin, aspirin, clopidogrel, novel anticoagulants) reviewed — pause decision made per Dr. Garge's advice

1 Week Before

Purchase Grade 2 Compression Stockings

Below-knee graduated compression stockings (class 2 = 23–32 mmHg) — must be worn immediately after procedure and for 1–2 weeks

Day Before

Shave legs (if instructed)

Shave from ankle to groin on the treated side if advised by the clinical team

Day Before

Hydration

Drink adequate water — being well-hydrated aids tumescent anaesthesia delivery and reduces DVT risk post-procedure

Day of Procedure

Clothing

Wear loose, comfortable trousers that can roll up above the knee. Avoid tight jeans. Bring compression stockings to the appointment.

Day of Procedure

No fasting required for most patients

Light meal is acceptable — no general anaesthesia means extended fasting is not routinely required

Day of Procedure

Arrange Transport

You CAN drive yourself home after RFA in most cases — local anaesthetic is in the leg only. Confirm with Dr. Garge's team at booking.

Day of Procedure

Bring Documents

ID, insurance card, Doppler ultrasound report, medication list, blood test results (if applicable)

1

Pre-Procedure Duplex Doppler Marking (Day of Procedure)

On the treatment day, a duplex Doppler ultrasound scan is performed with the patient standing — confirming the reflux pattern, marking the exact course of the diseased saphenous vein on the skin, identifying the saphenofemoral junction (SFJ) or saphenopopliteal junction (SPJ), and selecting the catheter entry point. This 'roadmap' is created by Dr. Garge directly before the patient lies down for treatment.

2

Positioning, Skin Preparation & Sterile Draping

The patient lies comfortably on the procedure table. The treated leg is cleaned with antiseptic solution (chlorhexidine) from foot to thigh. Sterile drapes are applied. The leg may be slightly elevated or flat depending on which vein is being treated. Compression is avoided at this stage to keep the vein filled and visible on ultrasound.

3

Ultrasound-Guided Access — 2mm Needle Puncture

Under direct ultrasound visualisation, a 19G needle punctures the great saphenous vein (GSV) — typically just below the knee for GSV treatment. A guidewire is advanced through the needle, the needle is removed, and a 6/7Fr introducer sheath is placed over the guidewire. The RFA catheter is then advanced through the sheath to the saphenofemoral junction (2–3cm from the junction). Real-time ultrasound confirms correct catheter position.

4

Tumescent Anaesthesia Injection — The Pain-Free Step

The most important step for patient comfort. Under continuous ultrasound guidance, dilute tumescent anaesthetic solution (lidocaine 0.1% in saline) is injected into the tissue SURROUNDING the target vein — creating a fluid jacket along the entire length of the vein to be treated. This takes 5–10 minutes but is critical: it numbs the area completely, compresses the vein onto the catheter, and protects surrounding nerves, skin, and deep structures from thermal damage.

5

Radiofrequency Energy Delivery — Sequential Segmental Heating

The catheter is activated — delivering radiofrequency energy to the vein wall at 85°C for 20 seconds per segment. The catheter is withdrawn 6.5cm per treatment cycle. Each pull-back takes approximately 20 seconds. The entire GSV from knee to saphenofemoral junction is treated sequentially — ensuring no segment is missed. Duplex Doppler ultrasound continuously monitors the closure and confirms adequate vein contraction.

6

Treatment of Varicose Tributary Veins (If Required)

After RFA of the main truncal vein, visible varicose clusters in the thigh or calf may be treated in the same session using micro-phlebectomy (avulsion of clusters through 1–2mm incisions) or ultrasound-guided foam sclerotherapy. This 'one-stop' approach treats both the feeding truncal vein and the visible varicosities in a single visit — maximum benefit per session.

7

Final Duplex Doppler Check — Confirming Closure

A final duplex Doppler ultrasound scan confirms successful closure of the treated vein — no blood flow visible within the ablated segment on colour Doppler. The junction is assessed to confirm no reflux. If any segment shows residual flow, additional treatment is applied before the patient leaves the treatment room. Closure is confirmed before discharge.

8

Compression Application, Dressing & Discharge Instructions

Compression bandage is applied over the treated leg from foot to thigh. Class 2 compression stockings (23–32 mmHg) are then worn over the bandage for the first 24 hours, then stockings alone for 1–2 weeks. Patient is encouraged to walk for 30 minutes before leaving. Discharge instructions cover: walking schedule, compression stocking care, activity restrictions, when to shower, warning signs, and follow-up Doppler appointment at 1 week.

Timeframe

What to Expect

Dos & Don'ts

Immediately After Procedure

Mild tightness along the treated vein. Bruising around needle entry site. Compression bandage + stockings applied. Walk 30 min before leaving.

✅ Walk 30 min before going home. ✅ Compression stockings ON. ❌ Do NOT sit still for > 1 hour.

Day 0–1 (First 24 Hours)

Tightness and bruising along vein course — normal post-RFA inflammatory response. Mild soreness on walking. Leg feels 'warm.

✅ Walk 30 min minimum every day. ✅ Keep stockings on. ✅ Paracetamol for soreness. ❌ No hot bath/sauna. ❌ No running.

Days 1–3

Most patients return to desk work. Bruising and tightness progressively reduce. Light activities comfortable.

✅ Return to desk work. ✅ Light cooking and walking. ❌ No gym. ❌ No heavy lifting. ❌ No cycling yet.

Days 3–7

Significant improvement in comfort. Stockings worn during the day. Swelling usually reducing.

✅ Continue compression stockings daily. ✅ Driving after Day 3 for most. ❌ No flight > 2 hours yet.

Week 1–2

Return to standing and light physical work. Follow-up Doppler at 1 week confirms successful closure. Stockings worn for full 2 weeks.

✅ Light exercise — walking, swimming from Week 2. ✅ Stocking compliance critical. ❌ No high-impact exercise.

Week 2–4

Full return to most physical activities. Treated vein progressively fibroses. Visible varicosities begin shrinking over this period.

✅ Gym, cycling, jogging from Week 2–3. ✅ Remove stockings after Week 2 unless advised otherwise.

Month 1–3

Visible varicosities fade as underlying reflux is eliminated. Treated vein scars internally and shrinks. Follow-up at 1 and 3 months.

✅ 3-month Doppler to confirm maintained closure. ✅ Report any new leg swelling or pain.

⚠️ Call Citi Vascular Immediately

Sudden significant calf swelling | Hot, red, hard cord along vein course | Fever > 38°C | Shortness of breath or chest pain

⚠️ These may indicate DVT or other complication — call +91-73375 83901 immediately

Clinical Outcome

Data / Rate

Source / Notes

Technical closure rate at 1 year

95–98%

Duplex Doppler confirmed — no blood flow in treated vein

Technical closure rate at 5 years

85–90%

Long-term follow-up RCT data — RFA vs surgical stripping

Symptom improvement (pain, heaviness, swelling)

85–90% of patients

VCSS (Venous Clinical Severity Score) improvement

Patient satisfaction at 1 year

90–95%

Published patient-reported outcome measures — RFA cohorts

Return to work

Average 1–2 days

Compared to 2–6 weeks for surgical stripping

DVT rate post-RFA

< 1%

Lower than surgical stripping — walking encouraged immediately post-RFA

Nerve damage rate

< 1% (RFA)

Lower than surgery due to tumescent protection of surrounding tissues

Recurrence at 5 years

~10–15% symptomatic recurrence

Due to new reflux in untreated veins or neovascularisation — not treated vein reopening

Superiority vs surgical stripping

Equal efficacy | better recovery | lower complication

Multiple RCTs including NICE UK guidance and EVOLVeS trial

Category

Risk / Side Effect

Frequency

Management

Very Common (>20%)

Bruising along treated vein course

Almost all patients

Self-resolving in 1–3 weeks. No treatment needed. Normal post-ablation response.

Very Common more than 20 percent

Tightness or cord sensation along vein

70 percent lasts 2-6 weeks

Normal fibrosing vein. Ibuprofen and warm compress. Resolves.

Common (5–20%)

Skin bruising and discolouration at puncture site

~30–50%

Fades within 2–4 weeks. Compression helps minimise.

Common (5–20%)

Phlebitis (superficial thrombophlebitis) of treated vein

~5–15%

NSAIDs + compression stockings + walking. Self-limiting 2–6 weeks.

Uncommon (1–5%)

Skin numbness / paraesthesia (nerve irritation)

~1–5% — usually medial calf

Usually temporary — resolves 3–6 months. Tumescent technique minimises this significantly.

Uncommon (1–5%)

Hyperpigmentation (skin darkening over vein)

~3–10%

Usually temporary — sun protection + time. Rare cases require dermatological input.

Rare (< 1%)

Deep Vein Thrombosis (DVT)

< 1% with walking protocol

Encouraged walking + compression immediately post-procedure dramatically reduces risk. DVT screening at 1-week Doppler.

Rare (< 1%)

Skin burn or thermal injury

< 0.1%

Prevented by tumescent anaesthesia — fluid jacket dissipates heat. Extremely rare with proper technique.

Rare (< 1%)

Endovenous Heat-Induced Thrombosis (EHIT) — extension of clot to DVT level

< 1%

Monitored on 1-week Doppler — anticoagulation if Grade 3–4 EHIT detected.

Feature

RFA

EVLT (Laser)

VenaSeal (Glue)

Surgery

Mechanism

Radiofrequency heat 85°C

Laser light energy 810–1470nm

Cyanoacrylate glue seals vein

Physical removal of vein

Anaesthesia

Tumescent (local)

Tumescent (local)

Local — minimal tumescent

General/spinal

Pain level

Minimal

Slightly more bruising

Minimal — no tumescent

Significant post-op pain

Hospital Stay

Same day

Same day

Same day

1–2 days

Return to Work

1–3 days

1–3 days

1–2 days

2–6 weeks

Closure Rate (1yr)

95–98%

95–98%

95–97%

95–98%

Compression Stockings

2 weeks

2 weeks

1 week only

Varies

Tortuous / large veins

Less suitable

Better

Best

Any

Allergies concern

❌ None

❌ None

⚠️ Glue allergy possible

❌ None

Cost Hyderabad (approx.)

₹40K–₹80K/leg

₹40K–₹80K/leg

₹50K–₹1L/leg

₹30K–₹60K/leg

Best For

Standard GSV/SSV | good vein access

Tortuous or small veins | younger patients

Avoid tumescent | faster | no heat

Perforator incompetence | complex anatomy

Not sure which technique suits you?

Duplex Doppler at Citi Vascular determines the right technique for YOUR vein anatomy.

 +91-73375 83901

Check Insurance Coverage

Many policies cover varicose vein treatment. We handle pre-authorisation.

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Differentiator

Specific Evidence

What This Means for You

Triple International Credentials

FRCR (Royal College of Radiologists, UK) | FNVIR (CMC Vellore) | EBIR (European Board of IR, Spain) | Fellowship (USA)

Three of the highest international IR certifications — globally verified. One of the few RFA practitioners in India hold all.

All Endovenous Techniques Available

RFA | EVLT (laser) | VenaSeal (glue) | MOCA (mechanochemical) — all available in-house

He recommends the right technique for YOUR anatomy — not the only technique his clinic offers

12+ Years Dedicated IR Experience

Specialised exclusively in image-guided minimally invasive vascular procedures

Not a general surgeon who 'also does' veins — vascular interventional radiology is his entire focus

15,000+ Procedures Performed

Total minimally invasive vascular interventions at Citi Vascular Hospital, KPHB

High procedure volume = refined technique, lower complication rate, faster procedure time

Real-Time Duplex Doppler Guidance

Every RFA procedure performed under continuous duplex ultrasound guidance — from access to closure confirmation

No 'blind' steps — every catheter position, tumescent injection, and closure confirmed under imaging

One-Stop Treatment

RFA + phlebectomy + sclerotherapy all performed in a single session when clinically appropriate

Maximum treatment in one visit — no repeat procedures for satellite veins

Transparent Pricing

All-inclusive costs discussed before procedure — no hidden charges

You know the full cost before agreeing to proceed

What We Offer

The Specifics

Why It Matters

Dedicated Vascular Interventional Suite

Full duplex Doppler USG + RF generator + laser unit + VenaSeal system — all in-house

All endovenous techniques available at one location — no external referrals needed

Pre-Procedure Duplex Doppler On-Site

Complete vein mapping performed at Citi Vascular before RFA — no separate radiology centre

One-stop pre-procedure planning and treatment in the same facility

Same-Day Discharge Protocol

Standard for all endovenous varicose vein treatments — monitored post-procedure, then walk and go home

Minimal disruption to work, family, and daily life

One-Stop Treatment Session

RFA + phlebectomy + foam sclerotherapy for satellite veins all performed in same session

Maximum clinical benefit per visit — no multiple return procedures

Insurance & Cashless Facility

All major TPAs, corporate mediclaim, government schemes | Pre-authorisation handled by Citi Vascular team

We prepare and submit documentation — you focus on recovery

1-Week Follow-Up Doppler

Mandatory post-RFA duplex Doppler at 1 week confirms vein closure and screens for EHIT/DVT

Safety check included — not an additional cost for most packages

Post-Procedure WhatsApp Support

48-hour check-in by Dr. Garge's team after every RFA procedure

Immediate access to expert guidance if any concern during recovery

Stage

Priya's Experience

Clinical Details

Presentation

5 years of left leg aching and heaviness | Visible bulging veins in calf | Ankle swelling by evening | Standing for 6 hours/day as teacher

CEAP Classification C3 (varicosities + oedema) | 6-year symptom history

Doppler Evaluation

Duplex Doppler at Citi Vascular — left GSV reflux 5.8 sec on Valsalva | Vein diameter 8mm | No DVT

Classic GSV reflux — ideal RFA candidate | Vein diameter and straightness confirmed suitable

Consultation

Dr. Garge explained RFA vs surgical stripping | Priya chose RFA — faster recovery for return to teaching

RFA + phlebectomy of prominent calf clusters planned in one session

Procedure Day

Arrived 9 AM | Leg marking 9:30 AM | RFA + phlebectomy completed by 10:45 AM | Walking by 11 AM

GSV ablated 35cm + 3 phlebectomy sites | Final Doppler confirmed complete closure

Recovery

Day 1: tight cord sensation + mild bruising | Day 2: desk admin tasks | Day 3: back to teaching

Significantly faster than the 6-week recovery she had feared from what friends described with surgery

1-Month Review

Visible varicosities 70% reduced | Leg heaviness resolved | Ankle swelling gone

1-week Doppler: GSV confirmed closed | 1-month: VCSS score improved from 6 to 2

Credential

Detail

Full Name

Dr. Shaileshkumar Garge

Qualifications

MBBS | MD (Mumbai) | DNB (Delhi) | FRCR (UK) | FNVIR (CMC Vellore) | EBIR (Spain/Europe) | Fellowship (USA)

Role

Director & Chief Vascular Physician | Senior Consultant Vascular & Interventional Radiologist

Hospital

Citi Vascular Hospital, KPHB Colony, Road No. 1, Hyderabad, Telangana 500072

RFA / Varicose Vein Expertise

RFA (ClosureFast) | EVLT (810nm/1470nm laser) | VenaSeal (cyanoacrylate) | MOCA | Ultrasound-guided foam sclerotherapy | Micro-phlebectomy

Experience

12+ years | 15,000+ minimally invasive vascular procedures across Hyderabad & Telangana

Other Specialisations

Laser, RFA, Embolisation, UFE/UAE, Varicocele Embolization, PAD, DVT, Pelvic Congestion Syndrome, Vascular Malformations

Technology

Dedicated Vascular Suite | Duplex Doppler | RF Generator | Laser Unit | VenaSeal System | Fluoroscopy

Hospital

Contact

Hours

Citi Vascular Hospital

+91-73375 83901

KPHB Colony, Road No. 1, Hyderabad, Telangana 500072 | Mon–Sat 9AM–6PM

Online Booking

citivascularcentre.com

WhatsApp + online booking | Same-day Doppler available | Free parking | Insurance assisted

✅

RFA = radiofrequency heat delivered via catheter — seals diseased saphenous vein from inside without any surgical incision

✅

95–98% technical closure rate at 1 year | NICE UK first-line recommendation ahead of surgical stripping

✅

Local (tumescent) anaesthesia only — no general anaesthesia, no intubation, no anaesthetic recovery

✅

Same-day discharge | Walk immediately | 1–3 days to office work | No surgical scar

✅

Both legs treated in one session | Phlebectomy + sclerotherapy in same visit | One-stop treatment

✅

All 4 techniques available at Citi Vascular KPHB — RFA, EVLT, VenaSeal, MOCA — Dr. Garge selects based on YOUR anatomy

✅

Dr. Shaileshkumar Garge FRCR (UK) | 12+ years | 15,000+ procedures | Continuous duplex Doppler guidance