Radiofrequency Ablation (RFA) for Varicose Veins in Chicago
Radiofrequency ablation (RFA), done with the ClosureFast system, closes a leaking vein in the leg from the inside, using radiofrequency heat delivered through a thin catheter under ultrasound guidance. Once the vein is closed, blood is redirected to healthier veins nearby, and the treated vein is gradually replaced by scar tissue. Dr. Nidal Elbaridi performs every procedure in the office at our South Loop and Streeterville locations.
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Workers’ Comp, HMO referral or complex insurance? Call (312) 414-1088.
Why a leg vein needs closing
Varicose veins develop when the valves that keep blood moving toward the heart stop working correctly. Blood pools inside the vessel and causes it to stretch and bulge. The underlying problem is called venous insufficiency. It is the source of both the visible veins and leg symptoms such as aching, heaviness, swelling and night cramps.
RFA treats that underlying problem. Controlled radiofrequency heat closes the great and small saphenous veins, the main surface veins of the leg, when ultrasound shows their valves are leaking. This is varicose vein treatment without surgery.
Also called
Radiofrequency ablation (RFA), endovenous radiofrequency ablation, or ClosureFast, Medtronic’s RFA system. RFA is one form of endovenous thermal ablation (EVTA), the general term for treatments that close a diseased vein from the inside with heat. Endovenous laser treatment (EVLT) is the other.
Nerve RFA is different from the radiofrequency ablation (ClosureFast) we use to close a faulty vein in the leg. Both use radiofrequency energy, but they treat different problems. For back, neck or joint pain, see radiofrequency nerve ablation.
Find out whether RFA is right for your veins
Every visit starts with a venous duplex ultrasound, so treatment is matched to what is actually happening in your veins.
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Workers’ Comp, HMO referral or complex insurance? Call (312) 414-1088.
It starts with a duplex ultrasound
A visual exam alone isn’t enough. Your evaluation begins with a venous duplex ultrasound, a non-invasive study that measures blood flow direction and velocity, identifies which vessels have valve failure, and shows whether the problem starts in the deep or superficial venous system.
Dr. Elbaridi reviews your ultrasound with you and performs your procedure himself. The right approach depends on the size and location of the affected veins, the severity of venous insufficiency, and your health history. RFA is one of several ways to close a vein, and the ultrasound shows which one fits.
Commonly treated veins are the great saphenous vein, the small saphenous vein and the accessory saphenous veins.
Who RFA is for
- Patients with varicose veins or venous insufficiency
- Leg pain, aching, heaviness, swelling, fatigue or cramping, often worse with long periods of standing or sitting
- Venous reflux confirmed by duplex ultrasound
- Symptoms not relieved by compression stockings, exercise or leg elevation
- Patients who want a minimally invasive treatment with little downtime
Who it isn’t for
RFA may not be appropriate if you:
- don’t have significant venous reflux on ultrasound
- have vein anatomy that isn’t suited to catheter treatment
- have an active blood clot (deep vein thrombosis or superficial thrombophlebitis)
- have an active skin or soft tissue infection near the treatment area
- have severe peripheral arterial disease with poor leg circulation
- are unable to walk or stay mobile after the procedure
- are pregnant (treatment is usually put off until after pregnancy)
- have symptoms mainly caused by a condition other than venous insufficiency
Not being a candidate for RFA doesn’t mean vein treatment isn’t possible. Ultrasound-guided foam sclerotherapy, Varithena, VenaSeal, microphlebectomy or conservative treatment may fit better.
How vein RFA is done
Vein closure procedures (EVLT, RFA, VenaSeal and Varithena) are done under ultrasound guidance, in the office.
1. Numbing
Local anesthetic only for most patients. Sedation is available if you want it. No general anesthesia is required.
Before RFA begins, a dilute numbing solution called tumescent anesthesia is placed around the vein under ultrasound guidance. It keeps you comfortable, protects nearby tissue from the heat, and presses the vein around the catheter so it closes more effectively. Most patients feel only minor discomfort during this step and stay awake throughout.
2. The catheter
A small catheter is placed into the abnormal vein, typically the great saphenous vein, using ultrasound guidance.
The catheter goes in through a small needle puncture in the skin, usually at or below the knee, under ultrasound guidance. No incision is needed, and there are no stitches. The puncture is covered with a small bandage.
3. Closing the vein
Radiofrequency energy delivered through the catheter heats the vein wall, and the vein collapses and seals shut. A mild sensation of warmth or pressure may be felt during the procedure.
How long it takes
The procedure itself typically takes 30–60 minutes per leg, depending on the size and number of veins treated.
Plan on being in the office for about 60–90 minutes in total. That includes check-in, ultrasound mapping, preparation, the procedure and your aftercare instructions.
Getting home
Most patients have vein RFA with local anesthesia alone, drive themselves home and return to normal daily activities the same day.
If sedation is used, please arrange for someone to drive you home, and plan to take the rest of the day off from work and other activities.
Recovery and what comes next
Walking, work and exercise
Patients walk immediately after the procedure, and most return to normal activities the same day. Post-procedure bruising and soreness are common but usually mild.
- Walking: right away, and encouraged
- Desk or light-duty work: the same day or the next day
- Jobs with long standing, heavy lifting or strenuous activity: a few days off may be recommended
- Light exercise: within 24–48 hours
- Running, weightlifting and other high-impact or intense leg workouts: usually after 1–2 weeks
Recovery time depends on the vein treated, how much was treated, and how you heal.
Compression stockings
You’ll wear compression stockings afterward, usually for 1–2 weeks:
- First 24–48 hours: day and night, taking them off only to bathe
- After that: during the day only, off while you sleep, for the rest of the 1–2 weeks
Stockings reduce bruising and swelling, improve comfort and support the treated vein while it heals. Dr. Elbaridi may adjust this for your procedure and recovery.
Follow-up ultrasound
A follow-up duplex ultrasound is done within the first week after RFA, usually 3–7 days after treatment. It confirms the treated vein has closed, checks that blood flows normally in the deep veins, screens for blood clots, and shows whether any more treatment is needed.
What happens to the vein
The treated vein closes and is gradually replaced by scar tissue. Blood is redirected to healthier veins nearby. A vein that has been successfully closed usually stays closed. However, new varicose veins can develop over time if the underlying tendency toward venous insufficiency continues.
Keep moving
Compression stockings, regular movement, and periodic follow-up help manage long-term recurrence. Walking is encouraged after treatment and helps circulation. Mild soreness, bruising, tightness or tenderness is common and usually improves over the first few days to weeks.
Call the office if you have:
- pain that keeps increasing instead of improving
- significant swelling in the treated leg
- redness, warmth or tenderness that keeps getting worse
- drainage from the treatment site
- fever or other signs of infection
- new numbness or tingling that concerns you
- questions about your stockings or recovery
Go to the emergency room right away if you have:
- sudden chest pain
- shortness of breath or trouble breathing
- coughing up blood
- severe leg swelling that gets worse quickly
- signs of a serious allergic reaction, such as facial swelling
Other ways we close a vein
Dr. Elbaridi performs each of these in the office. The ultrasound, and your own preferences, decide which one fits.
VenaSeal
Most patients need only local anesthetic; sedation is available if you want it. You’ll wear compression stockings afterward.
More about VenaSeal Foam injectionVarithena
A medicated foam injected through a small needle under ultrasound guidance. It fills the diseased vein and closes it, with no heat and no incision.
More about Varithena All treatmentsEVLT, sclerotherapy and microphlebectomy
Endovenous laser treatment (EVLT), ultrasound-guided sclerotherapy and microphlebectomy are covered in our varicose vein treatment guide.
Varicose vein treatment in Chicago
Dr. Nidal Elbaridi, MD
- Harvard Medical School phlebology training (2015)
- Medtronic VenaSeal and radiofrequency ablation certification (2019)
- Boston Scientific Varithena certification (2023)
Insurance and pre-authorization
Medical vein treatment is covered by most insurance when ultrasound confirms venous insufficiency. We verify benefits and pre-authorize before your procedure, so there are no surprise bills afterward. We do not charge out-of-network rates.
Most insurance accepted, including Medicare, Medicare Advantage, PPO and HMO plans. Coverage depends on medical necessity — we verify before your visit.
Before insurance approves RFA
Many insurance plans require conservative treatment before they approve RFA. Requirements vary by insurer and plan, and often include:
- documented symptoms, such as leg pain, heaviness, swelling, fatigue or skin changes
- a venous reflux ultrasound showing medically significant venous insufficiency
- a trial of graduated compression stockings, often for 6–12 weeks
- records showing symptoms continued despite compression, exercise, leg elevation and activity changes
Our office checks your plan’s requirements and handles the prior authorization.
What Chicago patients say about Loop
Dr. Elbaridi and the entire team are truly exceptional. Their bedside manner and genuine care make you feel like more than just another patient…
I’ve been coming to Loop Medical Center for my vein procedures with Dr. Nidal, and I couldn’t be more impressed…
Vein RFA questions, answered
Does vein RFA hurt?
Local anesthetic only for most patients, and sedation is available if you want it. A mild sensation of warmth or pressure may be felt during the procedure. Post-procedure bruising and soreness are common but usually mild.
How is this different from the RFA I had for my back?
Nerve RFA is different from the radiofrequency ablation (ClosureFast) we use to close a faulty vein in the leg. Both use radiofrequency energy, but they treat different problems. Nerve RFA is explained on our radiofrequency nerve ablation page.
Will I need to wear compression stockings, and for how long?
Yes. Compression stockings are usually worn day and night for the first 24–48 hours, then during the day only for the rest of 1–2 weeks. Dr. Elbaridi gives you specific instructions based on your treatment and medical history.
Will I need an ultrasound after RFA?
Yes. A follow-up duplex ultrasound within the first week confirms the vein has closed and that the deep veins are healthy and free of blood clots.
Can the vein come back?
A vein that has been successfully closed usually stays closed. However, new varicose veins can develop over time if the underlying tendency toward venous insufficiency continues.
Does insurance require compression stockings before RFA?
Often, yes. Many insurers require you to try compression stockings and other conservative treatment before approving vein ablation, commonly for 6–12 weeks. We verify benefits and pre-authorize before your procedure, so there are no surprise bills afterward.
Related pages
Vein Clinic
All vein treatmentsVaricose Veins
Read moreVaricose Vein Evaluation
Read moreVaricose Vein Treatment in Chicago
Read the guideDr. Nidal Elbaridi, MD
Meet Dr. ElbaridiRadiofrequency Nerve Ablation
RFA for nerve painSouth Loop vein clinic
1921 S Michigan AveStreeterville vein clinic
432 E Grand Ave, Ste ABook your vein evaluation at Loop Medical Center
Same-week appointments at our South Loop and Streeterville locations.
Opens our secure booking calendar — this page stays open.
Workers’ Comp, HMO referral or complex insurance? Call (312) 414-1088.