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Endovenous varicose vein surgery comes of age

by – February 18, 2017

On 12th March 2017, it will be 18 years since the UK’s first endovenous varicose veins surgery.

On that date in 1999, Mark Whiteley and Judy Holdstock treated a lady with varicose veins of one leg. They used a device called “VNUS Closure”. This has now evolved into radiofrequency ablation (RFA) of varicose veins.

Original VNUS Closure catheters used for first endovenous varicose veins surgery in UK by Mark Whiteley and Judy Holdstock

Original VNUS Closure catheters used for first endovenous varicose veins surgery in UK by Mark Whiteley and Judy Holdstock

Interestingly, this first patient returned for assessment one year ago. Scanning of the treated vein showed that over 16 years later, the treated varicose vein remained closed and no new varicose veins had appeared on that leg.

However, she had gone on to develop new varicose veins on the other leg. These were treated using our research-proven approach – endovenous laser ablation (EVLA) performed in accordance with The Whiteley Protocol, under local anaesthetic.

Endovenous varicose veins surgery – progression over 18 years

When Mark and Judy performed the first case in the UK, it was clear to them that this new approach had massive advantages over the old “tying and stripping” of varicose veins.

Immediately they started their research and development of the techniques, which they continue today. This research and development ensures that The Whiteley Clinic remains as one of the leading varicose vein clinics in the world.

Initially, patients only had the main veins treated with endovenous varicose veins surgery. These are the great and small saphenous veins. Very quickly, Mark and Judy realised that other veins needed to be treated in order to reduce the risks of varicose veins coming back again.

In 2001 they invented the Transluminal Occlusion of Perforators (TRLOP) technique, which was “re-invented” in the USA in 2007 and called Perforator Ablation Procedure (PAPS). This term should not be used and the original term, TRLOP, should be used for closing the perforator vein with an endoluminal device (ie: from within the vein).

Originally endovenous varicose veins surgery was performed in a hospital under general anaesthetic. In 2005, Mark and Judy moved the procedure into their own walk-in walk-out clinic and moved to using local anaesthetic only. Local anaesthetic is safer for the patient and reduces costs as well.

Over the last decade, Mark and the research team at The Whiteley Clinic have continued to research endovenous varicose veins surgery, checking how each device works and so ensuring that each patient should get the very best treatment.(see: https://www.ncbi.nlm.nih.gov/pubmed/?term=Whiteley+ms)

This is achieved by a combination of finding out how these techniques work optimally and, knowing this, making individual plans for each patient. Every patient has their own unique pattern and size distribution of varicose veins.

The Whiteley Protocol

Our research into how endovenous techniques actually work on the vein wall shows us why some doctors and clinics fail. We can identify why varicose veins can come back if the techniques are not used optimally. This knowledge is put into The Whiteley Protocol, which we continually review and update, as our research shows us more and more of what is going on.

It is through the use of The Whiteley Protocol that all patients coming to The Whiteley Clinic get the same outstanding quality of care, with the lowest possible recurrence rates, regardless of which one of our doctors they see.

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