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Recurrent varicose veins due to traditional surgery

by – February 9, 2017

Unfortunately recurrent varicose veins after treatment are very common in most practices. Indeed, many patients and doctors erroneously say that “varicose veins always come back”. There are many reasons for this.

The Whiteley Clinic specialises in the science of treating varicose veins. Because of this, we are able to ensure that patients who have varicose veins treated at The Whiteley Clinic under The Whiteley Protocol have the lowest possible chance of recurrence.

Bilateral recurrent varicose veins - 3 missed sources of varicose veins - came to The Whiteley Clinic for help - 1 and 2

Bilateral recurrent varicose veins – 3 missed sources of varicose veins – came to The Whiteley Clinic for help – 1 and 2

In addition, patients who have recurrent varicose veins having been treated elsewhere, frequently come to us for a diagnosis and second opinion.

Recurrent varicose veins due to 3 missed causes

This patient featured in the photographs had recurrent varicose veins after traditional surgery and foam sclerotherapy. She had been elsewhere and had different attempts at treatment.

Initially, in 2007, she had gone to a doctor who had recommended foam sclerotherapy. She had very big varicose veins. She underwent foam sclerotherapy and, not surprisingly, this made no effect to her veins.

Although foam sclerotherapy can work in some cases, research from The Whiteley Clinic has shown that in large veins with thick walls, sclerotherapy does not kill the vein (https://www.ncbi.nlm.nih.gov/pubmed/26790396). It is much more likely to produce clots and thrombus. This can result in brown stains and recurrent varicose veins quite quickly after treatment.

In 2012, she went to another surgeon who decided to strip her veins. Although she had successful stripping, this only addressed one of three problems causing her veins. In addition, the stripping itself caused a new problem as well.

The problem that the surgeon caused was that he used open surgery. Research from The Whiteley Clinic has shown that when you use the old open surgery (tying and stripping) for varicose veins, they just grow back again in a large number of people (https://thewhiteleyclinic.co.uk/research/published-research/varicose-veins-come-back-stripping-5-8-year-results/).

Bilateral recurrent varicose veins - 3 missed sources of varicose veins - came to The Whiteley Clinic for help - 3

Bilateral recurrent varicose veins – 3 missed sources of varicose veins – came to The Whiteley Clinic for help – 3

The second problem was that the surgeon missed incompetent perforating veins. Most vein surgeons in the UK still do not treat perforating veins. Prof Whiteley has published the reasons why these should be treated and he, and Judy Holdstock, invented the TRLOP operation for closing perforators in 2001 (https://thewhiteleyclinic.co.uk/research/published-research/incompetent-perforator-veins-recurrent-varicose-veins-trlop/).

The third problem was that the surgeon missed pelvic vein reflux. In women with varicose veins who have had children, one in five have varicose veins from pelvic veins. If this is missed it is one of the commonest causes of recurrent varicose veins after surgery (https://thewhiteleyclinic.co.uk/research/published-research/varicose-veins-come-back-dont-check-pelvic-veins/).

The Whiteley Protocol and recurrent varicose veins

Fortunately, this patient has now come to see us at The Whiteley Clinic. By using The Whiteley Protocol, all of these areas have been diagnosed by our specialist Clinical Vascular Scientist’s performing venous duplex ultrasonography.

This patient will have all of the areas treated in turn by The Whiteley Protocol. She will then have the lowest chance of ever getting recurrent varicose veins again, which is 3.3% per year. The Whiteley clinic has performed regular audits over the last 15 years to prove that their recurrence rate is consistently 3.3% per year which is the same as the rate of deterioration of a normal person, prone to getting varicose veins, who has never had them before. It is impossible to get lower than this rate.

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