5 stars out of 5 for vein book

Mark Whiteley's book, "Understanding Venous Reflux - the cause of varicose veins and venous leg ulcers" has been given 5 out of 5 by a health care professional who treats leg ulcers all of the time.

Understanding Venous Reflux - My Mark Whiteley
Simple to read yet revolutionary in content

The reviewer, a tissue viability nurse from Manchester, says that their previous understanding of venous disease and leg ulcers was "blown out of the water" by this book.

Read the whole review on:

http://www.amazon.co.uk/product-reviews/B005QBFBUC

Channel 4 - The Whiteley Clinic Prestige Stakes 2012

The Whiteley Clinic Prestige Stakes will be held at Goodwood Race course at 2:15pm on Saturday 25th August 2012.

This is the 4th year in a row that The Whiteley Clinic has sponsored a horse race at Goodwood.

The race is being televised on Channel 4 and will be shown live.

http://www.goodwood.co.uk/horse-racing/fixtures/fixtures/fixtures-2012/race-meet-saturday-25-august.aspx

Whiteley Clinic Summer Research Fellows 2012

The Whiteley Clinic Summer Research Fellows 2012
Alice Whiteley, Charlotte Thomas, Daniel Taylor

The 2012 Whiteley Clinic Summer Research Fellows are now in post and coming to the end of their research.

Alice Whiteley, Charlotte Thomas and Daniel Taylor (all pictured above) are performing research studies and audits into varicose vein treatments.

Their research includes projects on:

• The causes of recurrent varicose veins from other vein clinics and practices
• The evolution of endovenous surgery and minimally invasive vein techniques
• The long term results of thermoablation of the Great Saphenous vein

All of these projects will be presented and submitted for publication to try to help the world of Phlebology (or Vein Treatments) to move forwards a bit further.   

New invention - Whiteley Laser Sweat Ablation (LSA) Cannula

The Whiteley Laser Sweat Ablation (LSA) Cannula
- ensures a more even distribution of Laser Energy

On 25th July 2012, new Whiteley Laser Sweat Ablation (LSA) cannula was used for the first time on a patient by Mark Whiteley.

Mark introduced Laser Sweat Ablation (LSA) for the treatment of under arm sweating (Axillary hyperhidrosis) into the UK, performing the first operation in the UK in March 2009.

Since then, Mark and his team have been performing research and development to improve the results of this revolutionary new procedure.

The latest development is the Whiteley Laser Sweat Ablation (LSA) Cannula, which has a Patent Pending on it.

The cannula makes sure that the laser energy is passed into the skin at an exact angle, reducing the risks of under treatment or skin burns. It also makes the procedure easier for the doctor as the cannula glides across the inner surface of the skin - making the procedure quicker and easier.

The Whiteley Laser Sweat Ablation (LSA) cannula is now on sale exclusively through Premier Health Resources.

http://www.premier-health-resources.co.uk

Leg ulcer recurring over 19 years curable by Whiteley Protocol

Leg ulcer recurred over 19 years due to inadequate assessment.
Found to be completely curable under local anaesthetic by The Whiteley Protocol

This 58 year old lady came to The Whiteley Clinic. She had developed a right leg ulcer in 1993 and ever since then, the leg ulcer has kept recurring despite all treatment.

Her local surgeons had "operated" on her varicose veins on 2 different occasions and had told her that nothing more could be done for her surgically.

She has spent the last 19 years in tight compression bandages which slowly allow the ulcer to "heal" - only to recur shortly after the bandages are removed.

Desperate to be cured, she even went privately to a local "expert" surgeon who told her that the best thing to do was to give up work and stay at home with her leg up!

Her son heard about the high success rate of curing venous leg ulcers at The Whiteley Clinic and suggested she come to our Whiteley Clinic in London for assessment.

Her tests, performed by the Specialists at The Whiteley Clinic, showed that the previous 2 operations had completely missed the relevant vein - so in efffect she had never had any surgical treatment at all!

She is easily curable under local anaesthetic using The Whiteley Protocol -  in her case a combination of radial firing EVLA (endovenous laser), TRLOP (closure of perforators) phlebectomies and Foam scerotherapy.

Had she been referred to, and fully investigated by, a vein specialist earlier - rather than her doctors and nurses just assuming that the previous surgery had been successful in dealing with the underlying veins - then she wouldn't have had to suffer so much pain and inconvenience over the last 19 years.

www.legulcers.co.uk

OK Magazine - Mark Whiteley featured this week



Mark Whiteley is featured in OK Magazine
this week - Number 838
"You're so vein"

This week, Mark Whiteley is featured in OK Magazine in an article about the latest advances in Vein Treatments.

Mark discusses Radiofrequency Ablation, Endovenous Laser and the new Venaseal glue treatments for Varicose Veins.

Please see OK Magazine - Number 838 - "You're so vein"

Curable venous ulcer delayed by inappropriate referral

This patient came to The Whiteley Clinic with a leg ulcer on the right leg, with brown skin staining around the lower leg and visible varicose veins on standing.

Despite having a classic venous leg ulcer, he was referred to a plastic surgeon who charged him to say that the ulcer wasn't malignant - and despite several hundreds of pounds, no treatment was suggested or offered!!

Venous Ulcer of Left lateral (outer) ankle - brown stains typical of venous disease clearly seen on leg
Also varicose veins clearly seen - although not always present in venous ulcers
Purple pen mark above ulcer marking site of Incompetent Perforator Vein

When he came to The Whiteley Clinic, a consultation and examination revealed a previous vein operation about 10 years ago using the old "Stripping" method which we now know allows veins to grow back again - causing the same problem to recur (www.veinsstripping.co.uk).

Duplex Ultrasound report - The Great Saphenous vein has been stripped before - but has regrown in the mid portion.
The Small Saphenous Vein is huge (14mm) and there is reflux in Anterior Accessory Saphenous Vein and multiple incompetent perforators.
Patient can be cured by EVLA and TRLOP under local anaesthetic. 

The combination of brown discolouration of the skin at the ankle, a little swelling o the ankle and a leg ulcer made it virtually creating the problem was a venous leg ulcer - and therefore curable in most cases using The Whiteley Protocol(TM).

A venous duplex ultrasound showed that the Great Saphenous Vein had partially grown back again causing problems, and further venous reflux in the Small Saphenous Vein, Anterior Accessory Saphenous Veins and 4 incompetent Perforating Veins were causing the leg ulcer (see "Understanding Venous Reflux - The Cause of Varicose Veins and Venous Leg Ulcers").

All of these veins can be cured under local anaesthetic with a combination of Radial Firing EVLA for the long veins and TRLOP of the incompetent perforating veins.

Venaseal "superglue" for Varicose Veins now available at Whiteley Clinic

The Venaseal or "Superglue" Sapheon procdure performed by
Mark Whiteley at The Whiteley Clinic



The new Venaseal or "superglue" treatment for varicose veins is now available for private patients at The Whiteley Clinic in Guildford and London.

For more information please follow the link:

http://www.thewhiteleyclinic.co.uk/venaseal-sapheon-superglue-for-varicose-veins.html

Endovenous Training Videos on College of Phlebology

Mark Whiteley demonstrates how to perform ultrasound guided Seldinger access of the Great Saphenous Vein for "Keyhole Vein Surgery" - Medically known as "Endovenous Surgery". This technique is performed under local anaesthetic.

It is an essential part of endovenous surgery - whether it is for Endovenous Laser Ablation (EVLA), Radiofrequency Ablation (RFA) or for one of the newer techniques such as Venaseal Glue closure of the veins.

This is one of the educational videos available to members of The College of Phlebology (www.CollegeofPhlebology.com).

 

Selected highlights from the European Venous Forum

www.CollegeofPhlebology.com

Report of the selected highlights from The European Venous Forum (EVF) held in Florence, Italy on 28-30 June 2012 are now available in the members area of The College of Phlebology (www.CollegeofPhlebology.com).

This includes some very interesting research into a novel way of improving the results of Foam Sclerotherapy.

Mark Whiteley speaking at The EVF in Florence



13th Annual Meeting of the European Venous Forum
Florence 28 - 30th June 2012

Mark Whiteley of The Whiteley Clinic is an invited speaker at the 13th Annual Meeting of the European Venous Forum (link below).

On Thursday 28th June, Mark will be taking part in a debate about perforating veins:

Debate: Perforators veins need to be always treated
 - 10.20-10.32 For the motion: Mark Whiteley (UK)
 - 10.32-10.44 Against the motion: Massimo Cappelli
 - 10.44-11.10 Discussion

Perforating veins are described on: http://www.collegeofphlebology.com/perforator-veins/what-is-it/

and the treatment of perforators by TRLOP (Transluminal occlusion of perforators) is described on www.TRLOP.com.

If you are interested in knowing more about how perforating veins work and why they need treatment as part of the treatment of varicose veins and leg ulcers, then please see the easy to read book: "Understanding Venous Reflux - the cause of Varicose Veins and Venous Leg Ulcers".

More about the meeting on:
http://www.europeanvenousforum.org/evf2012/13th_congress_sc_prog.htm

Venaseal(TM) "Superglue" for Varicose Veins - Video

Video of the Venaseal(TM) "Superglue" treatment for Varicose Veins performed by Mark Whiteley at The Whiteley Clinic.

New questions answered in The College of Phlebology

"I take it that you still aim for a LEED of 60-90 j/cm even with 1470nm laser + radial fiber, and 10W, rather than 5-6W and 30-50 j/cm?"

College of Phlebology - "Ask an expert" section for Members to ask questions
www.CollegeofPhlebology.com 

New questions and answers about veins and vein treatments in The College of Phlebology membership area.

www.CollegeofPhlebology.com

EVLA Training Video on College of Phlebology website

EVLA Training Video on www.CollegeofPhlebology.com

Endovenous laser ablation (EVLA) videos are available to member of The College of Phlebology on www.CollegeofPhlebology.com.

There are also forums and an "Ask an Expert" section if you want to share something or if you have any questions.

www.CollegeofPhlebology.com

Venaseal "superglue" for Varicose Veins at The Whiteley Clinic

Mark Whiteley of The Whiteley Clinic performing a Sapheon Venaseal
"Superglue2 procedure of a varicose vein

This afternoon, Mark Whiteley of The Whiteley Clinic performed 2 procedures using the Venaseal "Superglue" for Varicose Veins made by Sapheon.

Both cases passed without hitch and both patients walked home within an hour of the procedure.

A scan performed straight after the minor operation showed the vein was closed right up to the top junction in the groin - precisely where the problem arises from.

Mark Whiteley of The Whiteley Clinic being filmed at The Clinical Exchange
for The College of Phlebology performing a Venaseal procedure

Both procedures were videoed in HD by the remote controlled cameras in our teaching facility - The Clinical Exchange.

These, with the superimposed duplex images, will form part of the Venaseal Teaching Video which will be featured on The College of Phlebology in the members area.

www.collegeofphlebology.com

Untreated pelvic veins may lead to Caesarian Section

Varicose veins seen arising from the buttock and area next to the vulva and running down into the leg
see www.vulval-varicose-veins.co.uk



This very interesting patient came to seek advice at The Whiteley Clinic. She was 4 months pregnant on her third pregnancy.

She had large varicose veins arising from the inner aspect of the leg next to the vulva (para-vulval veins) and from the buttock, leading down into large varicose veins of the leg. 

Varicose veins seen in para-vulval region in pregnancy running down into leg
see www.vulval-varicose-veins.co.uk

The large varicose veins continued upwards into the vulva and vagina, making her obstetrician worried about bleeding during a normal delivery and leading him to suggest that a caesarian section might be needed.


Close up of para-vulval veins in pregnancy
see www.vulval-varicose-veins.co.uk

Unfortunately this lady had seen these veins during her second pregnancy, but they weren't recognised as a sign of pelvic venous incompetence (or pelvic congestion syndrome) and so she was not referred for investigation and treatment.

As such, she is now in this dilemma with her third pregnancy. Had she been referred for treatment when the veins were first noticed, we could have fixed the underlying problem and she would not be facing the possibility of a caesarian for the risk of bleeding.

At The Whiteley Clinic we continually try to raise awareness and interest into this and other venous conditions, so that patients know that these conditions can be serious and also that treatment is available in specialised centres.

Also, we hope that Gynaecologists, Obstericians and mid-wives will also start diagnosing their patients with pelvic congestion syndrome and vulval varicose veins and let them know that their condition can be cured.

www.vulval-varicose-veins.co.uk

Whiteley Clinic on Faculty at Veith Symposium 2012

The Veith Symposium - www.veithsymposium.org

Mark Whiteley and Judy Holdstock of The Whiteley Clinic have been invited to be faculty members of The Veith Symposium 2012.

The Veith Symposium is an annual meeting held in New York. It is one of the largest and most prestigious meetings in vascular surgery in the world.

Mark Whiteley has been asked to speak as:

• Presenter:
• DEBATE: Perforator Ablation Is Not Overused
• Presenter
• Pelvic Reflux With Or Without Pelvic Symptoms (C2 Or Higher): Should We Treat And How?

 And be a panelist on one of the sessions on endovenous surgery

(For more details see: http://www.veithsymposium.org/index.php?pg=faculty-2012&letter=w)


Judy Holdstock has been asked to speak as:

• Presenter
• Detecting Iliac, IVC, Ovarian Vessels By Duplex Ultrasound

(For more details: http://www.veithsymposium.org/index.php?pg=faculty-2012&letter=h)

International Training Centre for EVLT

Next week in Barcelona, AngioDynamics is to announce that The Whiteley Clinic has been selected to be the international training centre for EVLT (EndoVenous Laser Therapy).

EVLT was the first endovenous laser system for the treatment of varicose veins and this is now owned by AngioDynamics.

AngioDynamics is fast becoming one of the most influential companies supplying equipment for varicose vein and other endovenous treatments. Their "NeverTouch" endovenous laser system, commonly called the "Gold Tip" laser or more correctly the VenaCure-EVLT, has been featured in the national news and has been increasing in popularity recently.

In addition, AngioDynamics also supplies a product for sclerotherapy and has other developments on the way to improve venous surgery and phlebology.

As part of their aim to improve the training of doctors performing endovenous laser treatment of veins, AngioDynamics are developing four training centres for EVLT in Europe - The Whiteley Clinic in the UK, and three other centres in the Netherlands, Germany and France.

The Whiteley Clinic has a very long history of training doctors, nurses and other healthcare professionals in endovenous techniques and the modern approach to venous surgery, having started running VNUS courses in 1999.

In 2009 The Whiteley Clinic developed a training arm, The Clinical Exchange (www.theclinicalexchange.com), to satisfy an increasing demand for training in different aspects of venous diagnosis and surgery including courses for:

microsclerotherapy and thread vein treatments
endovenous laser ablation
radiofrequency ablation of varicose veins
TRLOP closure of perforators
foam sclerotherapy
ambulatory phlebectomies

In addition The Clinical Exchange runs courses on laser sweat ablation and a pre medical taster course for students considering medical school.

The Clinical Exchange has a teaching room seating up to 48 people with live HD video links to the operating theatre and diagnostic duplex ultrasound room in The Whiteley Clinic. Delegates attending The Clinical Exchange can observe live cases and be in direct contact with the surgeon, vascular technologist and team throughout the procedures, enabling to ask questions as they occur.

With their reputation and history of excellent training in venous subjects, The Whiteley Clinic was selected by AngioDynamics as the lead centre of the four European training centres and is thus both the UK training centre and the International Training Centre for EVLT.

Vulval Varicose Veins on Embarrassing Bodies tonight

Mark Whiteley of The Whiteley Clinic has been asked to supply photos and facts about varicose veins of the Vulva for the TV Program "Embarrassing Bodies" to be screened tonight.

This very common, but much under recognised, problem has been treated successfully by The Whiteley Clinic since 2000. We have treated more patients with this condition than any other clinic in the world, and the veins are classified by The Whiteley Clinic Vulval Varicose Vein grading system:

	Description	Frequency seen at present
Grade 0	Normal – no varicosities nor venous reflux in vulva	Usual
Grade 1	No visible varicosities in vulva, but ultrasound proven reflux in vulval veins usually with para-vulval varicose veins seen on inner thigh	Common – 1 in 7 females presenting with leg varicose veins (1 in 5 of those post vaginal delivery)
Grade 2	Visible varicosities seen through mucosa of inner labia and lower vagina and ultrasound proven reflux in vulval veins.	Uncommon
Grade 3	Isolated varicosities seen on standing through skin of outer labia majora without a distortion of the general anatomy of the area	Very uncommon
Grade 4	Extensive varicosities of the labia, distorting skin and distorting the gross anatomy of the area on standing	Rare

see:

www.vulval-varicose-veins.co.uk

Mark Whiteley in the Telegraph.co.uk

Today (Sunday 27th May, 2012) the lovely Kate Shapland mentioned Mark Whiteley in her blog on The Telegraph.co.uk under the title:

"WHERE TO GO FOR VEIN REMOVAL"

Kate is specialist journalist who runs a blog called "The Leg Room"

http://fashion.telegraph.co.uk/beauty/news-features/TMG9290946/Beauty-Notebook-Super-skin.html

"Pioneering research means Whiteley is still leading the way"

For full article, see Surrey Advertiser 25th May 2012
Business News Extra - page 4

This week, Mark Whiteley and his research fellows at The Whiteley Clinic were featured in The Surrey Advertiser.

The article outlined the research and development that The Whiteley Clinic has supported over the last 10 years, in the areas of Varicose Veins treatments, Leg Ulcer Treatments and the development of Laser Sweat Ablation.

Students (ether students wanting a career in medicine or medical students who want to progress their careers) who would like to get involved in the research, are invited to contact The Whiteley Clinic on info@thewhiteleyclinic.co.uk.

Why is anyone still having vein stripping?

A 40 year old lady came to The Whiteley Clinic this week with recurrent varicose veins. She had been to a "vein expert" elsewhere, who had recommended vein stripping under a General Anaesthetic in 2003.

Patient had stripping of right Great Saphenous Vein 3 times
since 2003 by a "vein expert" in London

She had her vein stripped in 2003. Not surprisingly this vein came back again as they usually do after vein stripping.

Unfortunately she has gone back to the same "vein expert" twice since - and had further vein stripping under general anaesthetic twice since!!!

When examined at The Whiteley Clinic, she was found to had strip tract re-vascularisation - re-growth of the vein due to the stripping process.


Duplex ultrasound report showing that Great Saphenous Veins
has grown back - Strip Tract Revascularisation 

This sort of problem is found regularly after vein stripping procedures.

Since we brought endovenous surgery into the UK in 1999, we have not seen a single case of revascularisation in any of our patients following endovenous techniques.

This patient will be treated by 2 sessions of endovenous surgery to her leg, both under local anaesthetic. She will be able to walk home afterwards - true walk-in walk-out surgery.

If she had had this in the first place, it is unlikely she would have need the subsequent 2 operations that she had, nor what we need to do now.

For more information, see http://www.veinstripping.co.uk/

"Superglue" to treat Varicose Veins?

A "superglue" to stick varicose veins together needing virtually no anaesthetic at all, has been developed by Sapheon, a company in the United States.

The product, called "venaseal", is based upon a product that is already used successfully to close other blood vessels elsewhere in the body, such as arteries in the brain.

Only tiny amounts of the "venaseal" who are needed to treat the great saphenous vein, the commonest cause of varicose veins. The great saphenous vein runs between groin and ankle. To successfully treat varicose veins, surgeons usually need to treat the section of this vein that runs between groin and the knee.

Traditionally, this sort of surgery has been done under general anaesthetic using a "stripping" technique (www.veinstripping.co.uk). However over the last 10 years or so, general anaesthetic and stripping has been completely replaced by local anaesthetic endovenous laser ablation (EVLA) or radiofrequency ablation (RFA) in good vein practices.

However these ablation techniques use heat to destroy the vein and so require a lot of local anaesthetic to be injected through the skin and around the vein - a process called tumescence. Unfortunately the injection of tumescence can be very uncomfortable and even painful in some people.

Therefore over the last few years there has been a search for a way to close veins without using heat and thus not needing tumescent anaesthesia to be injected.

Several techniques have been suggested, some of which have been featured before in this blog or on The Whiteley Clinic websites, along with reasons why we do not support them.

Many doctors have started using ultrasound guided foam sclerotherapy which, although very useful in the small veins, has a very poor success rate in the larger veins such as the great saphenous vein. Therefore foam sclerotherapy is a great adjunct to treatments of the great saphenous vein, but it is not a good treatment by itself.

In contrast to this, "venaseal" is looking very promising. The glue is injected under ultrasound control through a single needle access point - the only area that needs any local anaesthetic for the procedure. The early data seems to suggest that the glue sticks the vein together and causes such an intense reaction, the vein appears to be completely destroyed.

If this proves to be the case, it could well be an improvment on endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) which both produce excellent results when used by experts in the correct manner.

In view of this exciting development, The Whiteley Clinic has decided to join the multicentre international trial of "venaseal".

Any patients who are interested in either having "venaseal" treatment at The Whiteley Clinic or being included in the study, are invited to contact us on info@thewhiteleyclinic.co.uk.

Ask an Expert on The College of Phlebology

Since the launch of The College of Phlebology (www.CollegeofPhlebology.com) last month, the "Ask and Expert" section has yielded some of the most useful tips for those people treating veins:

Examples of recently asked and answered questions by Members are:

Q - How far down the calf are you comfortable using laser for gsv or ssv, with regard to nerve damage risk?

Q - Is there any rationale for superiority of applying tumescent from proximal to distal rather than starting at the level of the sheath?

Q - I take it that you still aim for LEED of 60-90 j/cm even with 1470nm laser + radial fiber, and 10W, rather than 5-6W and 30-50 j/cm?

Q - for superficial truncal veins and accessory truncal veins, what depth from skin is your cutoff for avoiding laser for fear of producing a hard pigmented cord?

These questions and more are answered - and any member can pose any questions on vein treatments to the experts on the Advisory Board.

Curing leg ulcers

 First - an e-mail that arrived today:

"Hey Mark,
I saw one of your patients daughter in clinic yesterday .... I referred her to you she had terrible trouble with her leg ulcers, her daughter was so happy and singing your praises and mine for referring, she is off the morphine and walking around, her district nurses cant believe it, just thought I would let you know."

Leg ulcers are a horrible - you might not want to look at these pictures. However, in the UK about 500,000 people and in the USA some 2.5 million people regularly get these. They are often painful and always ruin peoples lives.



Day 1 - Patient has been told by a teaching hospital she will take 2 years to heal!!!
She is on morphine, dressings and compression bandaging. She underwent The Whiteley Protocol
having a scan to show the venous reflux and local anaesthetic endovenous surgery 

Leg ulcers are usually venous leg ulcers (cause by venous reflux) and they are almost always treated by nurses using dressings and compression bandages. 

Day 4 - 4 days after Whiteley Protocol treatment - ulcer left open to the air.
Nurses not allowed ot put dressings on ulcer 

Over the last few years, The Whiteley Clinic has been one of the new wave of vein clinics around the world that have introduced local anaesthetic endovenous surgery. We have spent years researching and understanding venous reflux and venous disease (see the book - "Understanding Venous Reflux - The cause of varicose veins and venous leg ulcers).

Day 8 - Scabs are allowed to form as they are nature's dressing - and allow health skin to form underneath.

We have developed The Whiteley Protocol - a system where we can assess all venous reflux (from Thread veins, through varicose veins, the venous eczema and leg ulcers).

Day 14 - Scabs about to fall off and no pain killers needed now.
Patient is up and walkiong about, pain free for the first time in months



By understanding the underlying problem with the venous reflux, we find that we are able to cure over 60% of people with leg ulcers. We cure them by fixing the reflux using our local anaesthetic endovenous methods and then allowing the ulcer to heal by exposure to the air (and NOT allowing dressings and bandages which now are not needed). 

Day 19 - Paitient well on way to healing, walking without aid and on no pain-killers
No comperession bandaging nor dressings have been used since.

Unfortunately, most people with leg ulcers never get a chance to be investigated and cured - and most doctors and nurses never tell their patients that local anaesthetic surgery might be able to cure their leg ulcers and stop them needing dressings and bandaging.

Look out for the Whiteley Clinic research into leg ulcers that is shortly to be published.

For more information see www.legulcers.co.uk

 

Pelvic cause of varicose veins - a problem often missed



Para-vulval veins - a sign of pelvic venous reflux. All of this lady's varicose veins came form her pelvis.
Traditional varicose veins surgery of the leg veins would not cure her.

This 38 year old lady, who has had 2 children, found her varicose veins on both side were getting worse.

A previous treatment of foam sclerotherapy to leg veins had not improved them - and in fact they had continued to deteriorate.

On examination, she had these large varicose veins at the top to the leg, on the inside of the thigh.

These veins are called para-vulval veins, as they emerge onto the leg next to the vulva. There is also a varicose vein coming onto the leg from the anal area.

This is a classic presentation of Pelvic Vein Reflux - www.vulval-varicose-veins.co.uk.

When this lady had her duplex ultrasound scan by the specialist vascular technologists at The Whiteley Clinic, it was found that her Great Saphenous Veins and Small Saphenous Veins on each side were perfectly normal.

If this patient had gone to a normal "vein specialist" it is likely she would have been offered stripping, endovenous laser or radiofrequency ablation - all of which would fail in her case.

What she needs is pelvic veins embolisation and then the legs can be treated successfully after the pelvic problem has been fixed.

www.vulval-varicose-veins.co.uk

For professionals, this and other complex problems will be discussed with members on www.collegeofphlebology.com

College of Phlebology - CollegeofPhlebology.com



The College of Phlebology - The Internet resource for excellence in Veins

The Whiteley Clinic is proud to be Gold Members of The College of Phlebology.

The College of Phlebology is an internet based college, that has something for everyone.

For patients / the public, the College of Phlebology website provides:

• information about veins and vein conditions
• the latest vein treatments
• a search facility to find your local vein expert

For doctors and nurses who treat veins - from thread veins, to varicose veins and leg ulcers:

• training videos
• news items about vein treatments
• forums to "ask an expert"
• use of MCPhleb if you treat thread veins
• use of FCPhleb if you operate on varicose veins and leg ulcers

Launched only a month ago, The College of Phlebology is rapidly growing as a resource for information and education for those interested in veins and vein conditions.

www.CollegeofPhlebology.com

Book ranked 3rd in class on Amazon

Understanding venous reflux - proving popular with varicose veins and ulcer patients

On today's rankings, "Understanding Venous Reflux - the cause of varicose veins and venous leg ulcers" was ranked 3rd best selling book on Amazon.co.uk in the class: "surgery > vascular".

It was also ranked 23rd under "medical research".

The book was written as a simple explanation as to how varicose veins and leg ulcers develop from the failure of the valves n the legs - by taking the reader through a step by step account of how the circulation works.

Research from the publishing company has shown that over 75% of the books have been bought by people who have varicose veins or leg ulcers - or friends or relatives of someone who has - and only 25% by healthcare professionals.

The aim of the book is to help anyone to understand how leg veins work - and what goes wrong with them.

The next book in the series - due out this summer - then outlines how these problems are best treated, and explains why some of the older techniques (and a few of the new ones) don't work effectively.

Why Thread Veins need Duplex before Treatment

This lady in her 50s, came to have her thread veins treated at The Whiteley Clinic this week.

Apparently "simple" Thread Veins of the Leg 

She had been to one General Practitioner who had told her that they were cosmetic veins only and did not need treatment. This general practitioner had then given her "cream" telling her the veins with disappear.

Of course they did not, has thread veins of the legs cannot be treated successfully with cream of any sort.

More importantly, no doctor can ever pass judgement on veins without a duplex ultrasound scan showing exactly what is going on in the veins, deeper in the leg.

Apparently "simple" thread veins of the leg on standing

Fortunately, she saw a second general practitioner who is aware that almost 90% of people with "simple" thread veins have underlying venous reflux - or "hidden varicose veins".

Therefore she was referred for a full assessment to The Whiteley Clinic.

Although no varicose veins are visible on standing, a full venous duplex ultrasound scan was performed which is shown below.

Duplex ultrasound scan - X shows venous reflux 

The venous duplex ultrasound scan shows that the great saphenous vein (GSV) has venous reflux from the upper thigh all the way to the ankle. The patch of thread veins is coming straight off one of the branches (or tributaries) from this.

Therefore blood refluxing or "falling" down the great saphenous vein (GSV) is impacting directly onto the thread veins.

If this patient had gone to a cosmetic practice or beauty clinic which did not have a minimum of hand held Doppler but preferably colour flow duplex ultrasound, it is likely that she would have been offered treatment for the thread veins.

Treating these thread veins without treating the underlying cause first is highly likely to cause a disaster, with the patch of thread veins becoming either larger and more difficult to treat (telangetic matting) or brown staining with a progression to more thread veins in the future.
The thread vein course run by The Whiteley Clinic at The Clinical Exchange teaches all delegates why it is essential to perform Doppler examination as a minimum, and how to perform it correctly.
For anyone who has read "Understanding Venous Reflux - the cause of varicose veins and venous leg ulcers" you will be able to see that this patient has phase 1 passive reflux. As such a hand held Doppler at the groin alone would not have been enough to diagnose her.
This patient needs endovenous laser ablation or radiofrequency ablation of her great saphenous vein before her thread veins can be successfully treated.
For more discussion about this and similar cases, please see www.collegeofphlebology.com.
For information about thread vein courses please see www.theclinicalexchange.com

Varicose veins of abdomen and leg ulcer

This patient presented to The Whiteley Clinic this week. He is in his 60s and has a leg ulcer of the right ankle.

Leg ulcer of right leg (covered by clear dressing)

As a child, he had been given injections penicillin into his thighs at age 3 weeks. As he grew up, his legs swelled regularly and he had "fragile veins".

Examining his abdomen when standing, he showed varicose veins of his right lower abdomen running from groin to flank.

Varicose veins of patients left lower abdomen groin up to the flank

This is a rare pattern of varicose veins seen when the veins deep in the pelvis have been blocked for a very long time.

For more pictures and discussion about this case, see: www.CollegeofPhlebology.com

Whiteley Clinic - 9th Fastest Growing UK Health Company

The Whiteley Clinic - 9th Fastest Growing UK Health Company

This month, the Plimsoll "UK Private Hospitals and Clinics Industry - Individual Company Analysis" was published.

The Plimsoll analysis compared the 261 UK Private Hospitals, Clinics and Health Companies.

We are delighted that The Whiteley Clinic came out as 9th fastest growing of these UK companies - and was listed as 22nd best trading partner.