This week, 15-year results prove varicose vein surgery at The Whiteley Clinic were published in an international journal (https://doi.org/10.1016/j.ejvs.2017.06.001).
Up until 1999, the usual way to treat varicose veins was stripping under a general anaesthetic. Research published from The Whiteley Clinic showed that that does not work in the majority of cases. (See: https://thewhiteleyclinic.co.uk/research/published-research/varicose-veins-come-back-stripping-5-8-year-results/)
On 12 March 1999, Mark Whiteley and Judy Holdstock from The Whiteley Clinic performed the first endovenous surgery for varicose veins in the UK.
Under an ultrasound guidance, Mark placed an endovenous catheter into the great saphenous vein. This vein causes varicose veins in a large number of patients. It is usually the vein that is stripped out.
Instead of stripping the vein, Mark and Judy used the endovenous catheter to heat the vein wall, permanently shrinking and closing the vein. This was the first case of endovenous thermoablation in the UK. It gave rise to the trend that you can now see all over the UK where people advertise endovenous laser and endovenous radiofrequency.
In the first case, Mark and Judy used radiofrequency ablation. Using a VNUS closure catheter, a radiofrequency electric current was passed into the vein wall. This heated the vein wall permanently shrinking it and destroying it. This meant that the cause of the varicose veins was permanently removed. Now Mark has turned to endovenous laser treatment rather than radiofrequency to get the best results.
Many doctors think that when they complete a procedure, they know if it has worked or not. This is often the case if someone is bleeding or there is a major problem.
However, with varicose veins, patients don’t only want to have the best treatment at the time. They also want to have the lowest chance of ever getting their varicose veins back again.
When Mark Whiteley started doing endovenous surgery for varicose veins, the idea was to reduce pain, get patients back to work or normal life quicker and to make smaller incisions and therefore a more cosmetic appearance. However, over the years, it has become clear that the major advantage of endovenous surgery, when performed by the Whiteley protocol, is that the treated varicose veins cannot come back again.
The only chance of getting varicose veins back again after treatment under The Whiteley Protocol is to open new veins up – which only occurs in 3.3% of cases per year. This is the same as the risk of developing varicose veins if you have never had them before.
Although this was clear to the researchers at The Whiteley Clinic many years ago, many doctors and patients will not trust theory and want to see the long-term results.
Therefore the research department at The Whiteley Clinic performed a study asking all of the early patients treated with endovenous surgery to return for assessments and scans.
The results have just been published.
The research has shown that unlike stripping, once a major vein has been treated with endovenous thermoablation, the vein is truly permanently destroyed.
Also in the research, patients were asked about their own satisfaction with the endovenous procedure and whether they would recommend it to friends and family. Overwhelmingly patients were happy with their treatment at The Whiteley Clinic using endovenous surgery, and almost all would recommend it to friends and family.
Of course, since that group of patients, our techniques of treatment have improved even further and are now available to anyone undergoing treatment at The Whiteley Clinic using The Whiteley Protocol.