Table of Contents

1 - The venous system of the lower limb
2 - Pressure in the venous circulation at rest
3 - Functional anatomy relating to the venous system of the legs
4 - The venous pump of the lower limb
5 - Valve failure and venous reflux (venous insufficiency)
6 - `Venous hypertension’ - an obsolete term
7 - Inflammation in venous reflux disease (chronic venous insufficiency)
8 - Pressure, flow and inflammation - how they relate in venous reflux disease
9 - Varicose veins - the `good guys’
10 - Patterns of reflux - passive and active phase reflux
11 - Conclusion

Promotional Information

This book has been written for two groups of people.
The first is for healthcare professionals who either are treating people with venous problems or who wish to do so.
The second is for members of the general public who want to understand more about the cause of varicose veins, thread veins of the legs and other venous conditions such as venous leg ulcers. After all, these conditions will affect almost half the population at some stage in their lives and currently is treated by a variety of people in a variety of ways - with very different outcomes. In order to make sure they or their loved ones get the best treatment, a good basic understanding of the problem by the healthcare professional is essential - and the ability to ask informed questions can often help to make sensible choices as to treatment options.

Although one would expect qualified people to have a very thorough understanding of their subject, research in varicose veins and venous reflux disease (or venous incompetence) has progressed at a rapid rate over the last decade or so. This, coupled with the unfortunate and incorrect view of a great many people both inside and outside healthcare that varicose veins are "only cosmetic", has meant that there is very little pressure on the majority of people who treat veins to keep up with the research and our new understanding of venous physiology.
Since 1999, I have been running courses to teach healthcare professionals how to treat varicose veins, thread veins and other venous conditions such as venous eczema and leg ulcers. During that time, it has amazed me that none of the professionals coming on my courses - whether surgeons, other doctors, nurses, beauty therapists or dentists - have been able to answer all of the simple questions that I pose about how veins work and the consequences of the valves failing in different veins. Although they all know that the basic problem is that the "valves aren't working", the problems that result from this and how it affects the legs seem something of a mystery to them. As understanding this is essential to good venous treatment, this is clearly very worrying.
I have written this book in a very simple style, that should be very easy to follow, much in the way that I teach on my courses. My understanding of varicose veins and venous reflux disorders has been amalgamated from my own research and experience, coupled with a large number of other influences learned from reading research papers and listening to research presentations from other research units. I have not attempted to reference any of these, as to try and find all of the influences that have contributed to my understanding of this subject over the last 20 years would be impossible.
I hope that this resulting book will take the reader through this fascinating subject and give them a deeper understanding of this very common problem. If by doing so this book helps healthcare professionals to understand their subject deeper and therefore review their treatment strategies, and helps members of the general public to understand what might be going on in their own legs or the legs of their friends and relatives in order that they may ask relevant questions of proposed treatments, then it has served its purpose.

About the Author

Mark Whiteley is a consultant venous surgeon and founder of The Whiteley Clinic, now in London, Guildford and Bristol. He is also a visiting Professor at the University of Surrey and an internationally recognised expert in venous disease and endovenous surgery.
Mark qualified in 1986 from St. Bartholomew's Hospital, completed the Bristol and Portsmouth surgical rotations before becoming a lecturer in surgery at the University of Bath followed by Oxford University. He was appointed as a consultant vascular surgeon at The Royal Surrey County Hospital before leaving and becoming 100% venous surgeon in 2005.
With his colleague Judy Holdstock, he introduced endovenous surgery into the UK by performing the first endovenous operation in the country on 12th March 1999. Mark founded The Whiteley Clinic in 2001 and invented the TRLOP operation with Judy Holdstock the same year.
He founded The College of Phlebology in 2011 and runs an annual international veins meeting in London, and founded the Leg Ulcer Charity - to empower patients to find a cure and to teach health care professionals that most leg ulcers can be cured without long tern dressings and bandages.
Mark has written this book and edited another book on veins; has written 15 chapters on veins in textbooks; has over 110 peer-reviewed research papers and has won multiple international and national prizes for his work in veins. He is regularly invited to meetings around the world to give guest lectures on venous diagnosis and treatments, or to chair or moderate sessions and sits on the international committee of the American Venous Forum. In 2017 he was given an award by Publons for being in top 1% of medical reviewers as a peer-reviewer for venous papers.
Committed to education, Mark runs the EVLT (endovenous laser treatment) International Academy for Angiodynamics 4 times per year since 2012 and runs courses, work experience, summer research fellows, extended research fellowships and PhD students.
He won a KTP grant from the UK government to set up a research department - performing confidential research for companies to advise them on how to optimise their vein treatments and to do his own research to ensure the efficacy of treatments used at The Whiteley Clinic as part of The Whiteley Protocol.
Mark is regularly featured in the national media in the UK: he has been recommended by Tatler for the last 10 years. He has had multiple appearances on TV including - "Embarrassing Bodies", "Harley Street", "Don't ask the Doctor" as well as being featured in featured in national newspapers and magazines regularly.

Reviews

Muhammad Salim; 5.0 out of 5 stars: Simple and well written. The book is easy to read. Concepts are explained in a simple yet concise way. I recommend this book to anyone who needs a good start in understanding venous reflux Disease. Kenneth U. Ekechukwu. 5.0 out of 5 stars: Superb new text on the block. Excellent, concise, and easy to read. Bold and truthful in debunking misleading, confusing time-honoured traditions and concepts. A firm foundation for understanding the basics of venous disease of the loer limbs and a reliable intro of the problem for the beginner and the dogmatic old horse. May benefit from some grammatical editing to remove distracting errors. IDMansell. 5.0 out of 5 stars: Understanding venous reflux: I'm a Tissue VViabilitynurse and was recommended this book by a vascular consultant at a conference in Manchester. I've been teaching district nurses and care home staff how to assess & manage venous leg ulcers for over 15 years. Part of the course includes pathophysiology of venous disease being a great believer in treat the cause not the symptom. That's been blown out of the water by the revelations in this book. It's easy and concise to read with good systematic approach to understanding venous reflux. "venous hypertension" becoming an obsolete term is initially difficult to assimilate, but the clarity of the text and research appears irrefutable. Although judging from the book there are still those out there who prefer to do just that. Chapeter 7 & 8 are the clinchers and worthy of careful analysis . The preceding chapters lead you in with simple explanation of the venous system and how it functions. Good use of simple diagrams support and consolidate the text. Some of the myths associated with venous hypertension are also refuted. Male vs female incidence obesity & pregnancy are disputed as well as other established so-called facts precipitating venous disease. I would recommend this book as does the author if you're any way involved in dealing with patients with venous ulcers both to correctly inform your patients and support staff in the assessment and management of venous leg ulcers. "once a leg ulcer patient always a leg ulcer patient" but not it would appear with venous hypertension but with venous reflux.