This morning, Prof Mark Whiteley gave a lecture about new treatments for varicose veins. This lecture was given at the European Vascular Course in Maastricht.
Varicose veins are the bulging veins seen on the surface of the legs on standing. They occur when the valves in the superficial venous system of the legs stop working.
In the past, doctors used to treat varicose veins by “stripping”. This process was firstly removing the underlying superficial truncal veins (a process called tying and stripping), followed by removing the bulging veins on the surface (a process called phlebectomy).
In March 1999, Prof Mark Whiteley and his colleague Judy Holdstock with the first people in the UK to perform the new endovenous surgery. Endovenous surgery is a process where a long device is passed into a vein guided by ultrasound. The device is then passed up the vein to the top. Depending on what technique is being used, local anaesthetic might be injected around the vein. The vein is then closed using one of several processes proven to destroy the veins.
Originally, the vein was destroyed using heat. This heat was generated in the vein by radiofrequency ablation or laser. More recently, devices using glue or a combination of mechanical trauma (a rotating wire) and sclerotherapy have been used. This last technique is called mechanochemical ablation (or MOCA) and is performed using a Clarivein catheter.
Not only the first in the UK to perform endovenous surgery, Prof Mark Whiteley has specialised in understanding how endovenous techniques work. Currently a visiting Prof at the University of Surrey, he has a research team at The Whiteley Clinic that works closely with the researchers at the University of Surrey.
This research collaboration has allowed Prof Whiteley and his team to investigate how laser, radiofrequency, glue, Clarivein and sclerotherapy actually work on the vein wall. By understanding this basic interaction, we are now able to predict which devices and techniques are likely to work and which ones are not. This can be tested before they are tested in animals or humans.
Using our university laboratory-based model, we are now able to save companies hundreds of thousands of pounds (or dollars or euros!). More importantly, we are able to stop needless animal and human experiments with devices that are destined not to work.
In devices that are able to work, we can now use our research to make sure that the settings used for each device are optimised before they are tested in patients.
In view of his expertise in endovenous surgery, Prof Mark Whiteley was asked to lecture about new treatments for varicose veins in 2018 beyond. The title of the talk was “Invasive superficial venous pathology treatment; what is new in 2018”.
During the lecture, Prof Mark Whiteley presented some new devices and treatments. Many had been brought to The Whiteley Clinic by companies for testing in the laboratory. Those that companies allowed to be presented were presented. Those that are still secret were obviously not presented today. In addition, Mark presented other devices and treatments from innovative companies and innovative doctors.
Overall, this is a very exciting time in venous surgery particularly in the treatment of varicose veins. Endovenous surgery using protocols such as The Whiteley Protocol, have shown to have excellent results in the medium to long-term. Not surprisingly, the National Institute of Health and Care Excellence (NICE) recommend endovenous surgery for varicose veins over and above the old stripping techniques.
The new treatments are all aimed at increasing the speed of surgery, reducing the discomfort further and also reducing the cost of treatments for patients.
The Whiteley Clinic will continue to monitor and check all new devices and treatments. In this way, we ensure that doctors at The Whiteley Clinic, using The Whiteley Protocol, are always offering their patients the optimal treatment that is currently available.