The course objective was to provide a comprehensive overview of "everything necessary" to establish an office-based vein practice. The director of the course, Dr Ian Franklin, Imperial College, London, UK, told CX Daily News why the course is so popular: “We have an absolute top-notch faculty, we’ve got the most eminent people in their fields, foam sclerotherapy, the biggest users of radiofrequency ablation, the biggest users of laser, all here. We’re exposing everyone to lots of different viewpoints.
This isn’t a partisan meeting, we don’t express any particular view about what therapy is the best, but try to show people, all the different techniques that are available and different hands-on training. We also demonstrate cannulation and diagnostic ultrasound, and seem to be hugely oversold; we could have filled three times over.”
It is becoming less and less accepted that varicose veins should be operated upon using surgical techniques. Now varicose veins can be managed in the office environment in three main ways: radiofrequency ablation, endovenous laser therapy, and foam sclerotherapy. The participants of the course were divided in groups and listened to explanations by members of the faculty and the companies exposing their products, as they moved along all the stands.
The first session focused on diagnostic venous ultrasound of the great and small saphenous veins, saphenofemoral and sapheno-popliteal junctions, perforator veins, and deep vein thrombosis using duplex scanning.
Session two was about tumescent anaesthesia under surgeon-friendly ultrasound control. This separates the saphenous vein from other tissues and bathes the vein in local anaesthetic. The vein is then ablated using a catheter, which generates heat in the vein with radiofrequency or laser. This method is done in an office, and has lead to varicose vein treatment transferring from the operating theatre to an office, from general to local anaesthetic. The patient walks out, after the treatment.
The third session focused on the demonstration of radiofrequency ablation with ClosureFAST and Celon RFITT catheter and VNUS, and also a range of different endovascular laser therapy techniques. The final session saw demonstations of radiofrequency ablations of perforating veins, ambulatory phlebectomy, and sclerotherapy for flare and thread veins. In all sessions, delegates were able to try out the devices in simulated procedures.
Dr Jonothan Earnshaw, Gloucestershire Royal Hospital, UK, demonstrated the technique using foam, one of the latest technologies. “We’re showing the delegates how it is possible to treat the majority of people with varicose veins disease with foam sclerotherapy, with low complications and a high success rate. Almost everyone is suitable for treatment with foam. The advantages are that it is a true outpatient treatment, you occasionally need to use local anaesthetic, but otherwise there is no analgesia or anaesthesia required, takes about 30 minutes to do, and patients can leave the hospital within the hour. Most of them don’t need any time off work, they can resume normal activities, although they do have a compression bondage on for the first two weeks,” said Earnshaw.
“Five years ago there was virtually nobody in the UK doing foam. There were lots of people in continental Europe – France and Germany – who have used foam sclerotherapy for many years and I think that’s where the idea came over from. Now I would say that approximately half of the vascular specialists in the UK will use foam sclerotherapy in some of their patients and a number of people have transferred the majority of their varicose vein practice to foam.”
Dr Philip Coleridge Smith, University College London, UK, who also presented foam sclerotherapy, commented on the ideas the treatment has generated. “They are very interested. I think many of the doctors who have passed by here today have not come across foam aclerotherapy at all, so that many of them are fascinated to see what we can do with foam compared to conventional surgery.”
Franklin is already planning on how to make next year’s course even bigger to include the increasing number of people interested in participating. “We’ll try and ensure that we include new catheters and new techniques, as they become available. So next year I’m sure it will be bigger.”
