Foam sclerotherapy is often recommended for the treatment of varicose veins. However in the Whiteley Protocol, we only use foam sclerotherapy for very small veins. This patient demonstrates why this is.
This patient came to The Whiteley Clinic in Bristol. Approximately 20 years ago he had the old style open surgery in his local hospital. This did not work.
His general practitioner then sent him to another local hospital. This hospital performed five sessions of foam sclerotherapy on one leg, and two on the other. They caused inflamed lumps which needed blood drained from them. They caused brown stains on both legs. However the large varicose veins all came back again.
When the patient came to The Whiteley Clinic, he underwent a specialist venous duplex ultrasound scan performed by one of our Whiteley clinic trained vascular technologists. As recommended by NICE, The Whiteley Clinic works in teams. All scans are performed by specialist vascular technologists who have been trained in the Whiteley Protocol.
The duplex ultrasound scan showed that the veins that should have been removed at surgery or closed with foam sclerotherapy were all still there. Although there was a little scar tissue, the veins had not been treated properly. Blood was refluxing down all of these veins and into the varicose veins.
This patient will be treated by the Whiteley protocol in the usual three stages:
Stage I – endovenous laser ablation, TRLOP closure of perforators and phlebectomies
Stage II – Ultrasound guided foam sclerotherapy of the remaining SMALL veins
Stage III – any cosmetic work for thread veins if he desires it.
By following the ordered approach of the Whiteley Protocol, he will join the large number of our patients that give us positive feedback and a very high patient satisfaction score.
The National Institute of Health and Clinical Excellence (NICE) states it is the second choice treatment. The first choice treatment is endovenous laser or radiofrequency ablation. (https://www.nice.org.uk/guidance/cg168)
Peer reviewed and published research from the The Whiteley Clinic has shown that sclerotherapy does not penetrate deeply into vein walls (http://www.ncbi.nlm.nih.gov/pubmed/26790396). This basic science has shown why foam sclerotherapy works in small veins with thin walls. However, it does not work very well at all in big veins with thick walls.
By tailoring treatments precisely to patients vein pattern, the Whiteley Protocol is able to use the Whiteley clinic’s prize-winning research to ensure.