Varicose veins and venous eczema in a patient on Warfarin – Sonovein (HIFU) and foam sclerotherapy
High-Intensity Focused Ultrasound (HIFU) is the latest technique to treat varicose veins. The HIFU machine is called “Sonovein“.
HIFU is completely non-invasive. The ultrasound is beamed across the skin from the outside of the body. It is designed to focus at one point inside the body. This point then heats up because of the focused ultrasound.
In the Sonovein machine, one ultrasound system allows the surgeon to see the target vein. The second focused ultrasound system can then treat it.
Because the system is non-invasive, it is completely safe to use in anticoagulated patients.
An 80-year-old man came to The Whiteley Clinic with severe left varicose veins and venous eczema. The venous eczema was on the outside ankle. There were also dark skin changes on the inner ankle.
When varicose veins are causing eczema and skin damage, it is called CEAP C4 (clinical class 4).
By the NICE clinical guidelines, this is an indication for varicose vein treatment. Both the guidelines and research shows that venous eczema and varicose veins can be cured. By doing so, the risks of going on to venous leg ulcers reduce significantly.
However, this gentleman was anticoagulated on warfarin. As such, he did not want to have surgery.
Therefore, we treated him with the Sonovein followed by ultrasound-guided foam sclerotherapy.
Varicose veins and venous eczema in anticoagulated patient on Warfarin – Sonovein (HIFU) and foam sclerotherapy
The Sonovein was used to close a large vein called the small saphenous vein. This was 10 mm in diameter. In addition, the Sonovein was used to close incompetent perforators.
This treatment reduced the pressure and flow in the varicose veins and in the veins at the ankle. The patient felt an improvement.
A few weeks later, ultrasound-guided foam sclerotherapy was then used to complete the treatment. This was used in the varicose veins and also the “stasis veins”. This use is explained in the book “Leg Ulcer Treatment Revolution“.
Four months after his first treatment, the patient had an excellent result and was back to a completely normal life. He had not stopped his anticoagulation for a single day. He had not had any incisions at all or catheters placed in any veins. He had only had injections with needles smaller than those used for a normal blood test.
Without a doubt, HIFU (Sonovein) is going to become a disruptive technology in vein surgery, as recently predicted by Prof Mark Whiteley.
HIFU (Sonovein) is exclusively available in the UK at The Whiteley Clinic.
0330 058 1850
Book a consultation >
