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Why is our protocol needed?


In the past (and unfortunately also today, in a great many practices) patients with varicose veins or other vein problems are seen by doctors who are not vein specialists. Most vascular surgeons spend most of their time performing aneurysm repair, arterial bypass surgery or carotid endarterectomy – NOT dealing with veins or venous problems.

Although arterial procedures are very worthwhile and that take a lot of skill, they do take a very long time and also use a completely different set of skills that are required for venous surgery. Thus anyone with a good arterial practice will not have the time to develop their understanding of venous disease nor the skills they will need to provide the best treatments of varicose veins and other venous problems.

Varicose veins are also treated by general surgeons and sometimes by dermatologists, radiologists or General Practitioners. Similarly, unless these doctors have given up their other work and decided to spend most of their time treating veins, they doctors spend most of their time treating other conditions and so do not develop the understand or skills to diagnose the problem and to provide the latest treatments performed the optimal way.

Up until 1999, the only way to treat varicose veins was by tying and stripping veins. In March 1999, Mark Whiteley introduced endovenous surgery into the UK by performing the first radiofrequency ablation (in those days VNUS® Closure®) in the UK. This was closely followed by endovenous laser ablation (EVLT® and then EVLA) and ultrasound guided foam sclerotherapy.

Initially all of these techniques were promoted as minimally invasive or “keyhole” vein surgery techniques with the advantages of being less painful and better cosmetic results. However following prize-winning research by Mark Whiteley of the The Whiteley Clinic in 2005, it was shown that stripping cause the veins to grow back again whereas if these techniques were used correctly, the veins did not come back again.

Unfortunately a lot of doctors, clinics or hospitals have “jumped on the bandwagon” and have got trained in one or two of the techniques such as foam sclerotherapy or radiofrequency ablation or endovenous laser – but have not developed the understanding of when to use them nor how to use them optimally. As such not everybody who performs endovenous techniques gets the same excellent results that are expected by patients at The Whiteley Clinic.

Put in simple terms, if two people give a Ferrari to drive, one was Jenson Button and one was a vascular surgeon, they would both have the same equipment but will probably not get the same result when using it! Exactly the same happens when someone uses one of the new endovenous techniques without fully understanding it and spending time to train adequately.

Therefore The Whiteley Protocol® is a way of ensuring that all doctors using the new techniques get similar results to those obtained by Mark Whiteley and Judy Holdstock, without having to go through all of the research and development that they did to get to their level of understanding and expertise.