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Endovenous Laser Treatment – A Live Demonstration

Endothermal Ablation. During endothermal ablation, the veins affected by reflux are treated from the inside with heat energy.  I perform this under local anaesthetic under ultrasound guidance. With an ultrasound probe on the skin, the unhealthy vein is located and the skin overlying the vein is numbed with local anaesthetic and then a small needle is inserted into this vein. Through the needle a fine catheter is inserted into the vein and advanced along the vein under the skin and positioned accurately to the site where the superficial vein joins the deep vein, confirmed by ultrasound. The vein is then … Continue reading »

New for 2018: The Comprehensive Review of Varicose Veins, Varicose Eczema, Leg Ulcers, Hand Veins

Comprehensive Review of All Aspects of Lower Limb Vein Conditions.

Everyone knows that venous disease is common and important. The Bonn Vein Study is one of the largest and most quoted medical studies looking at how common venous disease is. It looked at over 3000 adults: the participants completed a questionnaire, they were examined carefully and they underwent an ultrasound scan. They were allocated into one of 7 classes. C0 being a completely normal assessment with no signs of vein abnormality all the way to C6 which is an open leg ulcer. There are … Continue reading »

What is the best treatment for varicose veins?

National Guidance on the Treatment of Varicose Veins

In 2013, The National Institute for Health and Care Excellence – NICE- published clinical guideline CG168 and stated that patients with varicose veins should be referred to a vascular service – a team of healthcare professionals who have the skills to undertake a full clinical and duplex ultrasound assessment and who can provide the full range of treatment options.

NICE recommends:

  • Endothermal ablation should be the first option
  • Ultrasound Guided Foam Sclerotherapy the second option
  • Surgery is now the last resort.

During endothermal ablation, the veins affected by … Continue reading »

What is the cause of Varicose Veins, Varicose Eczema and Leg Ulcers?

Although surface varicose veins are pretty obvious, the cause of varicose veins is deeper under the skin. It is a problem called superficial venous reflux.

That is a defect in the one-way valves that keep blood flowing in the correct direction. Venous valves are delicate folds in the lining of the vein that open and close keeping blood flowing in the correct direction. In the legs, healthy vein valves direct blood from the foot upwards back towards the heart. When the one-way valves in the veins do not work properly, gravity can pull the blood downwards … Continue reading »

Varicose Veins Complications

In this post, I will cover the major complications of varicose veins.

The medical complications are

    • Phlebitis
    • Varicose Eczema
    • Leg Ulcers
    • Deep Vein Thrombosis. .

Phlebitis should really be called Superficial Vein Thrombophlebitis. In this condition, thrombus or clot formation is the main concern and threat. In Superficial Vein Thrombophlebitis there is thrombus – or clot – in the superficial vein, and inflammation in the tissue surrounding the vein. Often, a tubular-shaped lump can be felt which is red, tender and painful. The most frequently affected vein is the saphenous vein on the inner … Continue reading »

Phlebitis – A Serious and Sometimes Fatal Condition

Phlebitis is a medical term indicating that there is inflammation in the vein. Most commonly it affects the superficial leg veins and it is associated with localised swelling — a lump- which is red, tender and warm and sometimes the lump actually feels hot and painful.

Often, phlebitis comes on out of the blue for no apparent reason but very occasionally I see phlebitis as complication of some cancers, intravenous arm catheters used in hospital — drips – or sometimes as a reaction to some very irritant intravenous injections such as chemotherapy.  The standard case of superficial leg vein phlebitis seen … Continue reading »

Latest on Deep Vein Blood Flow

Mr Christopher Lattimer

Mr Christopher Lattimer

This week, I am very grateful to Mr Christopher Lattimer for writing about his reflections on the first day of the Spring Meeting of the Venous Forum at the Royal Society of Medicine. This meeting is the largest conference in the United Kingdom dedicated exclusively to the diagnosis and treatment of vein conditions. Chris completed his specialist vascular training at St Thomas’ Hospital and King’s College London. He is an expert in vein disease and has carried out important research on venous haemodynamics (how … Continue reading »

Phlebitis Is A Serious Condition – It Can Cause DVT

Earlier this month I saw a patient who was referred to me by his General Practitioner with phlebitis. His GP had been treating him with antibiotics and if anything, his leg was getting worse.

Now treating phlebitis with antibiotics is simply wrong and I am going to tell you the truth about phlebitis.

What happens in Phlebitis

What happens in Phlebitis

Phlebitis is simply a medical term indicating that there is inflammation in the vein. Most commonly it affects the superficial leg veins and it is associated with … Continue reading »

Steam For Varicose Veins

We already have reliable and effective endo-venous thermal ablation techniques for the treatment of superficial venous reflux causing varicose veins. These endo-venous thermal ablation techniques use very fine catheters to heat the vein from the inside to a temperature at which the vein is instantly closed and devitalised. Typically, Laser (EVLT) or Radio-Frequency (VNUS Closure) energy is used. So why do we need another one?

Well, sometimes, the vein to be treated is particularly tortuous (twisty) making it difficult to advance the straight catheter up inside it, or perhaps the vein is very … Continue reading »

New Treatment for DVT and Tips on How to Avoid One

DVT in Left Leg

DVT Left Leg Causing Swelling

The National Institute for Health and Clinical Excellence (NICE) has just issued its final appraisal determination on the use of rivaroxaban (also known as Xarelto) as an alternative to warfarin for the treatment of deep vein thrombosis (DVT) and prevention of recurrent DVT.

Estimates suggest that more than 46,000 people in England and Wales will develop a DVT in 2012, rising to more than 50,000 people in 2016, due in part to the rising population.

Up until now, warfarin has been the … Continue reading »