What is it about?

In March 1999, Mark Whiteley and Judy Holdstock performed the first "keyhole" surgery for varicose veins in the UK. They used radiofrequency ablation - in those days called "VNUS Closure". In this study, the team at The Whiteley Clinic reviewed patients 15 years after the treatment. All of the treated veins remained closed. Only 1 in 16 had a small part of the vein re-open leading to a new varicose vein. 100% of patients were happy that they had chosen this treatment and 98% said they would recommend it.

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Why is it important?

When we started "keyhole" treatments for varicose veins - now called "endovenous treatment" - in 1999, some "experts" went into the press saying that if it went wrong, patients could always resort to stripping. This research shows that these "experts" had got it the wrong way around! Using heat to destroy the varicose vein stopped the vein growing back again - a process we have shown happens t most people after vein stripping. Also, although these results were reported from radiofrequency ablation, they are actually showing the effect of heat on the vein wall. Hence endovenous laser should be able to produce just as good results. Even more importantly, as these results were the 15 years follow up of our early operations, it must be remembered that in those days we had only the very first endovenous devices and very poor ultrasound compared to that available today. As such, we are amazed that many units performing endovenous surgery today are not able to report results as good as we were getting with the old equipment, 15 years ago. Hence, we suggest that anyone getting worse results than those reported here should look at their techniques very carefully.

Perspectives

This research shows that even with the oldest system for "keyhole" endovenous surgery for varicose veins, we were able to obtain excellent long-term results. This suggests that any endovenous treatment for varicose veins using heat (ie: radiofrequency, laser, steam, microwave) should be able to produce the same excellent long-term results, provided that the doctors are using the right protocols. Also, the fact that no new veins were found to be caused to form as part of the healing process, shows the great advantage of this sort of endovenous surgery over the old stripping.

Professor Mark S Whiteley
The Whiteley Clinic

Read the Original

This page is a summary of: Fifteen Year Results of Radiofrequency Ablation, Using VNUS Closure, for the Abolition of Truncal Venous Reflux in Patients with Varicose Veins, Journal of Vascular Surgery, October 2017, Elsevier,
DOI: 10.1016/j.jvs.2017.08.015.
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