Prof Mark Whiteley, MS FRCS(Gen) FRCSEd MBBS - The Whiteley Clinic - Consultant Venous Surgeon and Phlebologist

Prof Mark Whiteley

MS FRCS(Gen) FRCSEd MBBS

The Whiteley Clinic

Consultant Venous Surgeon and Phlebologist

Guildford, London and Bristol | United Kingdom

Main Specialties: Vascular Surgery

Additional Specialties: Endovenous surgery

ORCID logohttps://orcid.org/0000-0001-6727-6245

Prof Mark Whiteley, MS FRCS(Gen) FRCSEd MBBS - The Whiteley Clinic - Consultant Venous Surgeon and Phlebologist

Prof Mark Whiteley

MS FRCS(Gen) FRCSEd MBBS

Introduction

Primary Affiliation: The Whiteley Clinic - Guildford, London and Bristol , United Kingdom

Specialties:

Additional Specialties:

Research Interests:

Experience

Jun 2001
Whiteley Clinics
Executive Chairman / Consultant Vascular Surgeon
Jun 2001
The Whiteley Clinic
Executive Chairman / Consultant Vascular Surgeon

Publications

242Publications

1079Reads

30Profile Views

225PubMed Central Citations

Is Size Important? The French Experience.

European Journal of Vascular and Endovascular Surgery

https://doi.org/10.1016/j.ejvs.2019.04.032

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July 2019

Recurrent Varicose Veins

Venous Disorders

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2018
13 Reads

A description of the 'smile sign' and multi-pass technique for endovenous laser ablation of large diameter great saphenous veins.

Phlebology 2018 Sep 28;33(8):534-539. Epub 2017 Sep 28.

1 The Whiteley Clinic, Guildford, Surrey, UK.

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http://dx.doi.org/10.1177/0268355517734480DOI Listing
September 2018
23 Reads
1.920 Impact Factor

Pelvic venous reflux in males with varicose veins and recurrent varicose veins.

Phlebology 2018 Jul 31;33(6):382-387. Epub 2017 Aug 31.

1 The Whiteley Clinic, Guildford, Surrey, UK.

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http://dx.doi.org/10.1177/0268355517728667DOI Listing
July 2018
12 Reads
1.920 Impact Factor

Response to "Pelvic venous reflux in male: Varicocele?"

Phlebology 2018 07 9;33(6):432-433. Epub 2018 Jan 9.

1 The Whiteley Clinic, Stirling House, Surrey, UK.

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http://dx.doi.org/10.1177/0268355517752169DOI Listing
July 2018
11 Reads
1.920 Impact Factor

Letter Re: Evaluation of sodium tetradecyl sulfate and polidocanol as sclerosants for leg telangiectasia based on histological evaluation with clinical correlation.

Authors:
Mark S Whiteley

Phlebology 2018 04 14;33(3):213-214. Epub 2017 Dec 14.

1 The Whiteley Clinic, Guildford, UK.

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http://dx.doi.org/10.1177/0268355517748251DOI Listing
April 2018
10 Reads
1.920 Impact Factor

Exacerbation of alopecia areata: A possible complication of sodium tetradecyl sulphate foam sclerotherapy treatment for varicose veins.

SAGE Open Medical Case Reports

A 40-year-old woman with a history of alopecia areata related to stress or hormonal changes was treated for bilateral primary symptomatic varicose veins (CEAP clinical score C2S) of pelvic origin, using a staged procedure. Her first procedure entailed pelvic vein embolisation of three pelvic veins using 14 coils and including foam sclerotherapy of the tributaries, using 3% sodium tetradecyl sulphate. Following this procedure, she had an exacerbation of alopecia areata with some moderate shedding of hair. Subsequently, she underwent endovenous laser ablation under local anaesthetic without incident. Seven months after the pelvic vein embolisation, she underwent foam sclerotherapy of leg and labial varicose veins using sodium tetradecyl sulphate. Two days following this procedure, she had a severe exacerbation of alopecia areata with gross shedding of hair. These two episodes of exacerbation of alopecia areata appear to be associated with sodium tetradecyl sulphate foam sclerotherapy of veins.

https://europepmc.org/articles/PMC5459345

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2017
12 Reads

Diagnosis of stenosis within the popliteal-femoral venous segment upon clinical presentation with a venous ulcer and subsequent successful treatment with venoplasty.

SAGE Open Medical Case Reports

This case study reports the diagnosis and treatment of a lower limb venous ulcer with abnormal underlying venous pathology. One male patient presented with bilateral varicose veins and a right lower limb ulcer. Upon investigation, full-leg duplex ultrasonography revealed total incompetence of the great saphenous vein in the left leg. In the right leg, duplex ultrasonography showed proximal incompetence of the small saphenous vein, and dilation of the anterior accessory saphenous vein, which remained competent. Incidentally, two venous collaterals connected onto the distal region of both these segments, emerging from a scarred, atrophic popliteal-femoral segment. An interventional radiologist performed venoplasty to this popliteal-femoral venous segment. Intervention was successful and 10 weeks post procedure ulceration healed. Popliteal-femoral venous stenosis may be associated with venous ulceration in some cases and may be successfully treated with balloon venoplasty intervention.

https://europepmc.org/articles/PMC5672999

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November 2017

Suprapubic varicose vein formation during pregnancy following pre-pregnancy pelvic vein embolisation with coils, without any residual pelvic venous reflux or obstruction.

SAGE Open Medical Case Reports

Suprapubic varicose veins are usually indicative of unilateral iliac vein occlusion and venous collateralisation. We report two cases of suprapubic varicose veins following pelvic vein embolisation and subsequent pregnancy; both presented without residual pelvic venous reflux or pelvic venous obstruction. In both cases, there was no significant flow in the suprapubic veins indicating that they were not acting as a collateral post-pregnancy. One patient had this venous abnormality treated successfully with TRansluminal Occlusion of Perforators, followed by foam sclerotherapy to the main part of the suprapubic vein. This patient has since completed the reminder of her lower limb varicose vein treatment. We suggest that pregnancy may have caused prolonged intermittent compression of the left common iliac vein, and that this, together with the physiological impact of previous embolisation procedures, obstructed venous drainage from the left leg resulting in collateral vein formation within the 9-month gestation period.

https://europepmc.org/articles/PMC5557157

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August 2017

Radiofrequency-induced thermotherapy (RFiTT) in a porcine liver model and ex vivo great saphenous vein.

Minim Invasive Ther Allied Technol 2017 Aug 2;26(4):200-206. Epub 2017 Feb 2.

a The Whiteley Clinic , Guildford , Surrey , UK.

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https://www.tandfonline.com/doi/full/10.1080/13645706.2017.1
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http://dx.doi.org/10.1080/13645706.2017.1282520DOI Listing
August 2017
69 Reads
1.180 Impact Factor

Factors affecting optimal linear endovenous energy density for endovenous laser ablation in incompetent lower limb truncal veins - A review of the clinical evidence.

Phlebology 2017 Jun 12;32(5):299-306. Epub 2016 May 12.

1 The Whiteley Clinic, Stirling House, UK.

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http://dx.doi.org/10.1177/0268355516648067DOI Listing
June 2017
47 Reads
1 Citation
1.920 Impact Factor

Mechanochemical ablation causes endothelial and medial damage to the vein wall resulting in deeper penetration of sclerosant compared with sclerotherapy alone in extrafascial great saphenous vein using an ex vivo model.

Journal of vascular surgery. Venous and lymphatic disorders

Nonthermal, tumescentless devices are the next generation of minimally invasive devices to treat varicose veins. We aimed to investigate the effects of mechanochemical ablation (MOCA) using ClariVein (Vascular Insights, Quincy, Mass) on ex vivo great saphenous vein with histology and immunofluorescent staining.Extrafascial great saphenous veins were harvested during surgery for varicose veins and were treated ex vivo for 10 to 11 minutes with either liquid sclerotherapy or the use of ClariVein, with and without 3% sodium tetradecyl sulfate. Veins were sectioned and subjected to hematoxylin and eosin staining and immunofluorescent staining for endothelial and smooth muscle cell markers (CD31 and α-actin) to assess overall damage and cell death in the vein wall compared with control sections.Histologic observations confirmed intimal damage from ClariVein, as has been previously shown; however, medial damage was also evident, which was not observed in control or liquid sclerotherapy sections. Immunofluorescent staining in the three sections studied showed a 42% decrease in CD31 staining and 27% mean reduction in α-actin staining up to a depth of 300 μm with liquid sclerotherapy. This cytotoxic effect was significantly enhanced by MOCA with a reduction in CD31 staining just above 60% and a 46% mean decrease in α-actin staining noted up to a depth of 300 μm. Far greater reductions in staining compared with sclerotherapy were observed up to a depth of 600 μm.MOCA using 3% sodium tetradecyl sulfate increases the penetration of the sclerosant and its effect into the vein wall and shows superior rates of tissue destruction compared with liquid sclerotherapy alone. In this model, it appears not solely to damage the endothelium but also to shear the medial layer, creating small lesions into which sclerosant can flow and exert its cytotoxic effect.

https://doi.org/10.1016/j.jvsv.2016.12.009

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May 2017
13 Reads

Response to letter: Long-term follow-up results of patients undergoing transjugular coil embolisation.

Phlebology 2017 04 19;32(3):215. Epub 2016 Nov 19.

The Whiteley Clinic, Guildford, Surrey, UK.

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http://dx.doi.org/10.1177/0268355516680726DOI Listing
April 2017
6 Reads
1.920 Impact Factor

One-year results of the use of endovenous radiofrequency ablation utilising an optimised radiofrequency-induced thermotherapy protocol for the treatment of truncal superficial venous reflux.

Phlebology

Background In previous in vitro and ex vivo studies, we have shown increased thermal spread can be achieved with radiofrequency-induced thermotherapy when using a low power and slower, discontinuous pullback. We aimed to determine the clinical success rate of radiofrequency-induced thermotherapy using this optimised protocol for the treatment of superficial venous reflux in truncal veins. Methods Sixty-three patients were treated with radiofrequency-induced thermotherapy using the optimised protocol and were followed up after one year (mean 16.3 months). Thirty-five patients returned for audit, giving a response rate of 56%. Duplex ultrasonography was employed to check for truncal reflux and compared to initial scans. Results In the 35 patients studied, there were 48 legs, with 64 truncal veins treated by radiofrequency-induced thermotherapy (34 great saphenous, 15 small saphenous and 15 anterior accessory saphenous veins). One year post-treatment, complete closure of all previously refluxing truncal veins was demonstrated on ultrasound, giving a success rate of 100%. Conclusions Using a previously reported optimised, low power/slow pullback radiofrequency-induced thermotherapy protocol, we have shown it is possible to achieve a 100% ablation at one year. This compares favourably with results reported at one year post-procedure using the high power/fast pullback protocols that are currently recommended for this device.

https://doi.org/10.1177/0268355517696611

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March 2017

The effect of a subsequent pregnancy after transjugular coil embolisation for pelvic vein reflux.

Phlebology 2017 Feb 9;32(1):27-33. Epub 2016 Jul 9.

1 The Whiteley Clinic, Stirling House, Guildford, Surrey, UK.

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http://dx.doi.org/10.1177/0268355515623898DOI Listing
February 2017
27 Reads
1.920 Impact Factor

Implication of foam sclerosant inactivation by human whole blood in a laboratory setting.

Phlebology

Background During sclerotherapy, it has been recommended to confirm intravenous placement of the needle by aspirating blood into the sclerosant syringe. This may inactivate some, or all of the sclerosant. Aims To quantify the volume of human blood needed to completely inactivate 1 ml of sodium tetradecyl sulphate, and comparing fresh blood and blood that has been stored in an ethylenediaminetetraacetic acid tube. Methods A series of manual titrations were carried out following a procedure developed at STD Pharmaceutical Products Ltd (Hereford, UK) and listed in the British Pharmacopeia. Three percent of sodium tetradecyl sulphate stock solutions were made with increasing volumes of blood and titrated against benzethonium chloride to determine the active concentration (% w/v) of sodium tetradecyl sulphate remaining in the solution. Results A calculated approximation showed 0.3 ml of blood is required to fully inactivate 1 ml of 3% sodium tetradecyl sulphate when made into a foam. A comparison was made between the use of fresh blood and blood stored in ethylenediaminetetraacetic acid tubes. Blood stored in ethylenediaminetetraacetic acid tubes showed more inactivation of sodium tetradecyl sulphate, but this was not significant at the P ≤ 0.05 level. Conclusion The data from our study have shown that a minimum of 0.3 ml of fresh blood is required to inactivate 1 ml of 3% sodium tetradecyl sulphate as a foam and it is not significantly affected by storing blood in an ethylenediaminetetraacetic acid tube. Our methodology suggests that during foam sclerotherapy treatment, blood should not be aspirated into the syringe to confirm position, and that ultrasound guidance is more appropriate for needle placement.

https://doi.org/10.1177/0268355517708468

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January 2017
13 Reads

Letter regarding the role of radical surgery in the management of CEAP C5/6 and lipodermatosclerosis.

Authors:
Mark S Whiteley

Phlebology 2016 12 20;31(10):769. Epub 2016 Jul 20.

Visiting Professor, Faculty of Health and Biomedical Sciences, University of Surrey, Surrey, UK and The Whiteley Clinic, 1 Stirling House, Stirling Road, Guildford, GU2 7RF.

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http://dx.doi.org/10.1177/0268355516660657DOI Listing
December 2016
7 Reads
1.920 Impact Factor

Pelvic congestion syndrome masquerading as osteoarthritis of the hip.

SAGE Open Med Case Rep 2016 9;4:2050313X16683630. Epub 2016 Dec 9.

The Whiteley Clinic, Guildford, UK; Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.

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http://dx.doi.org/10.1177/2050313X16683630DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153020PMC
December 2016
2 Reads

Letter regarding embolization is not essential in the treatment of leg varices due to pelvic venous insufficiency.

Authors:
Mark Whiteley

Phlebology 2016 Sep 5;31(8):588. Epub 2016 May 5.

The Whiteley Clinic, Guildford, UK

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http://dx.doi.org/10.1177/0268355516647319DOI Listing
September 2016
6 Reads
1.920 Impact Factor

Long-term results of transjugular coil embolisation for pelvic vein reflux - Results of the abolition of venous reflux at 6-8 years.

Phlebology 2016 Aug 17;31(7):456-62. Epub 2015 Jun 17.

The Whiteley Clinic, Guildford, Surrey, UK Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK

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http://dx.doi.org/10.1177/0268355515591306DOI Listing
August 2016
30 Reads
3 Citations
1.920 Impact Factor

The comparative impact of conservative treatment versus superficial venous surgery, for the treatment of venous leg ulcers: A systematic review of the impact on patients' quality of life.

Phlebology 2016 Mar 8;31(2):82-93. Epub 2015 Apr 8.

The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey, UK Faculty of Health and Biomedical Sciences, University of Surrey, Guildford, Surrey, UK.

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http://dx.doi.org/10.1177/0268355515581278DOI Listing
March 2016
20 Reads
1.920 Impact Factor

Media Damage Following Detergent Sclerotherapy Appears to be Secondary to the Induction of Inflammation and Apoptosis: An Immunohistochemical Study Elucidating Previous Histological Observations.

Eur J Vasc Endovasc Surg 2016 Mar 17;51(3):421-8. Epub 2016 Jan 17.

University of Reading, Institute for Cardiovascular and Metabolic Research, School of Biological Sciences, Reading, Berkshire RG6 6AS, UK.

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https://linkinghub.elsevier.com/retrieve/pii/S10785884150082
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http://dx.doi.org/10.1016/j.ejvs.2015.11.011DOI Listing
March 2016
10 Reads
1 Citation
2.490 Impact Factor

Media Damage Following Detergent Sclerotherapy Appears to be Secondary to the Induction of Inflammation and Apoptosis: An Immunohistochemical Study Elucidating Previous Histological Observations.

European Journal of Vascular and Endovascular Surgery

Traditionally, sclerotherapy has been thought to work by the cytotoxic effect of the sclerosant upon the endothelium alone. However, studies have shown that sclerotherapy is more successful in smaller veins than in larger veins. This could be explained by the penetration of the sclerosant, or its effect, into the media. This study aimed to investigate intimal and medial damage profiles after sclerosant treatment.Fresh human varicose veins were treated ex vivo with either 1% or 3% sodium tetradecyl sulphate (STS) for 1 or 10 minutes. The effect of the sclerosant on the vein wall was investigated by immunofluorescent labelling of transverse vein sections using markers for endothelium (CD31), smooth muscle (α-actin), apoptosis (p53) and inflammation (intercellular adhesion molecule-1 [ICAM-1]). Polidocanol (POL; 3%) treatment at 10 minutes was similarly investigated.Endothelial cell death was concentration- and time-dependent for STS but incomplete for both sclerosants. Time, but not concentration, significantly affected cell death (p > .001). A 40% and 30% maximum reduction was observed for STS and POL, respectively. Destruction of 20-30% of smooth muscle cells was found up to 250 μm from the lumen after 3% STS treatment for 10 minutes. POL treatment for 10 minutes showed inferior destruction of medial cells. Following STS treatment and 24-hour tissue culture, p53 and ICAM-1 were upregulated to a depth of around 300 μm. This effect was not observed with POL.Inflammatory and apoptotic markers show the same distribution as medial cell death, implying that sclerotherapy with STS works by inducing apoptosis in the vein wall rather than having an effect restricted to the endothelium. Incomplete loss of endothelial cells and penetration of the sclerosant effect up to 250 μm into the media suggest that medial damage is crucial to the success of sclerotherapy and may explain why it is less effective in larger veins.

https://doi.org/10.1016/j.ejvs.2015.11.011

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January 2016
15 Reads

Transvaginal duplex ultrasonography appears to be the gold standard investigation for the haemodynamic evaluation of pelvic venous reflux in the ovarian and internal iliac veins in women.

Phlebology

To assess the suitability of transvaginal duplex ultrasonography to identify pathological reflux in the ovarian and internal iliac veins in women.A retrospective study of patients treated in 2011 and 2012 was performed in a specialised vein clinic. Diagnostic transvaginal duplex ultrasonography in women presenting with symptoms or signs of pelvic vein reflux were compared with the outcomes of treatment from pelvic vein embolisation. A repeat transvaginal duplex ultrasonography was performed 6 weeks later by a blinded observer and any residual reflux was identified.Results from 100 sequential patients were analysed. Mean age 44.2 years (32-69) with mode average parity of 3 (0-5 deliveries). Pre-treatment, 289/400 veins were refluxing (ovarian - 29 right, 81 left; internal iliac - 93 right, 86 left). Coil embolisation was successful in 86/100 patients and failed partially in 14/100 - 5 due to failure to cannulate the target vein. One false-positive diagnosis was made.Currently there is no accepted gold standard for pelvic vein incompetence. Comparing transvaginal duplex ultrasonography with the outcome from selectively treating the veins identified as having pathological reflux with coil embolisation, there were no false-negative diagnoses and only one false-positive. This study suggests that transvaginal duplex ultrasonography could be the gold standard in assessing pelvic vein reflux.

https://doi.org/10.1177/0268355514554638

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2015
12 Reads

Transvaginal duplex ultrasonography appears to be the gold standard investigation for the haemodynamic evaluation of pelvic venous reflux in the ovarian and internal iliac veins in women.

Phlebology 2015 Dec 16;30(10):706-13. Epub 2014 Oct 16.

The Imaging Clinic, Mount Alvernia Hospital, London, UK.

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http://dx.doi.org/10.1177/0268355514554638DOI Listing
December 2015
17 Reads
3 Citations
1.920 Impact Factor

The impact of hand reflexology on pain, anxiety and satisfaction during minimally invasive surgery under local anaesthetic: a randomised controlled trial.

Int J Nurs Stud 2015 Dec 26;52(12):1789-97. Epub 2015 Jul 26.

The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey GU2 7RF, UK; Faculty of Health and Biomedical Sciences, University of Surrey, Guildford, UK. Electronic address:

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http://dx.doi.org/10.1016/j.ijnurstu.2015.07.009DOI Listing
December 2015
10 Reads
2.250 Impact Factor

Randomized controlled trial to compare the effect of simple distraction interventions on pain and anxiety experienced during conscious surgery.

European journal of pain (London, England)

High levels of anxiety during surgery are associated with poorer post-surgical outcomes. This prospective, non-blinded randomized controlled trial aimed to compare the effectiveness of four intraoperative distraction interventions for anxiety and pain management during minimally invasive venous surgery under local anaesthetic.407 patients presenting with varicose veins at a private clinic, were randomized to one of four intraoperative distraction interventions or treatment as usual. All participants received endovenous thermoablation and/or phlebectomies of varicose veins. After losses to follow-up, 398 participants were entered into the analysis. Participants were randomly allocated to one of the following intraoperative distraction techniques: patient selected music (n = 85), patient selected DVD (n = 85), interaction with nurses (n = 81), touch (stress balls) (n = 80) or treatment as usual (TAU, n = 76). The state scale of the STAI, the Short-form McGill pain questionnaire and numeric rating scales were used to assess intraoperative pain and anxiety.Intraoperative anxiety ratings were significantly lower when participants interacted with nurses, used stress balls or watched a DVD during surgery compared to treatment as usual. Intraoperative pain ratings were significantly lower than treatment as usual when participants interacted with nurses or used stress balls during surgery. Patients' satisfaction was not significantly impacted by intraoperative distractions.The use of simple intraoperative distraction techniques, particularly interacting with nurses, using stress balls or watching a DVD during surgery conducted under local anaesthetic can significantly improve patients' experiences.

https://doi.org/10.1002/ejp.675

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December 2015
14 Reads

Glue, steam and Clarivein--Best practice techniques and evidence.

Phlebology

In July 2013, the National Institute of Health and Clinical Excellence (NICE) recommended "endothermal" ablation (meaning endovenous thermal ablation) is the first line treatment for truncal venous reflux in varicose veins. The initial endovenous thermoablation devices were radiofrequency ablation and endovenous laser ablation. More recently, Glue (cyanoacrylate), endovenous steam and Clarivein (mechanochemical ablation or MOCA) have entered the market as new endovenous techniques for the treatment of varicose veins. Glue and Clarivein do not require tumescent anaesthesia and do not use heat and therefore termed non-tumescent non-thermal (NTNT). Steam both requires tumescence and is also a thermal technique (TT). This article reviews the current position of these 3 new technologies in the treatment of varicose veins.

https://doi.org/10.1177/0268355515591447

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December 2015
14 Reads

Randomized controlled trial to compare the effect of simple distraction interventions on pain and anxiety experienced during conscious surgery.

Eur J Pain 2015 Nov 30;19(10):1447-55. Epub 2015 Jan 30.

The Whiteley Clinic, Guildford, UK.

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http://dx.doi.org/10.1002/ejp.675DOI Listing
November 2015
6 Reads
5 Citations
2.930 Impact Factor

Glue, steam and Clarivein--Best practice techniques and evidence.

Authors:
Mark S Whiteley

Phlebology 2015 Nov;30(2 Suppl):24-8

The Whiteley Clinic, Guildford and London, UK

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http://dx.doi.org/10.1177/0268355515591447DOI Listing
November 2015
20 Reads
1.920 Impact Factor

Modified Tessari Tourbillon technique for making foam sclerotherapy with silicone-free syringes.

Phlebology

The longevity of foam made using sodium tetradecyl sulphate and gas (air or a CO2:O2 mixture) is increased significantly if silicone-free syringes are used over the normal syringes containing silicone oil lubrication. However, the plungers in silicone-free syringes start sticking after several passages when making foam for sclerotherapy, preventing the smooth injection of the resulting foam. We describe a three syringe technique which allows foam to be made using the Tessari Tourbillon 'three-way stopcock' principle between two syringes, but with the foam ending up in a third syringe which has not undergone multiple passages of the plunger. This allows a smoother injection of the resultant foam, which is particularly useful when injecting small diameter veins under ultrasound control.

https://doi.org/10.1177/0268355514554476

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October 2015
14 Reads

Modified Tessari Tourbillon technique for making foam sclerotherapy with silicone-free syringes.

Phlebology 2015 Oct 6;30(9):614-7. Epub 2014 Oct 6.

The Whiteley Clinic, Stirling House, Guildford, Surrey, UK.

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http://dx.doi.org/10.1177/0268355514554476DOI Listing
October 2015
14 Reads
1 Citation
1.920 Impact Factor

Strip-tract revascularization as a source of recurrent venous reflux following high saphenous tie and stripping: results at 5-8 years after surgery.

Phlebology

We have previously reported strip-tract revascularization 1 year following high saphenous ligation and inversion stripping. This study reports the 5-8 year results in the same cohort.Between 2000 and 2003, 72 patients presented with primary varicose veins and had undergone high saphenous ligation and inversion stripping plus phlebectomies with or without subfascial endoscopic perforator surgery. Of the 64 patients who had attended for follow-up at 1 year, 35 patients (male:female, 16:19; 39 legs) underwent duplex ultrasonography 5-8 years after surgery (response rate 55%). Duplex ultrasonography was performed and all strip-tract revascularization and reflux and groin neovascularization was documented.Eighty-two percent of legs of patients showed some evidence of strip-tract revascularization and reflux. Full and partial strip-tract revascularization and reflux was seen in 12.8% and 59% of limbs of patients, respectively, and 10.2% limbs of patients had neovascularization only at the saphenofemoral junction only. Seven limbs of patients showed no revascularization.Five to eight years after high saphenous tie and stripping, 82% of legs of patients showed some strip-tract revascularization and reflux and 12% showed total revascularization and reflux of the stripped great saphenous vein.

https://doi.org/10.1177/0268355514535927

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October 2015
15 Reads

Strip-tract revascularization as a source of recurrent venous reflux following high saphenous tie and stripping: results at 5-8 years after surgery.

Phlebology 2015 Sep 20;30(8):569-72. Epub 2014 May 20.

The Whiteley Clinic, Guildford, Surrey, UK Faculty of Health and Biomedical Sciences, University of Surrey, Guildford, Surrey, UK

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http://dx.doi.org/10.1177/0268355514535927DOI Listing
September 2015
30 Reads
1 Citation
1.920 Impact Factor

Endovenous surgery for recurrent varicose veins with a one-year follow up in a patient with Ehlers Danlos syndrome type IV.

Phlebology

We present a woman with severe symptomatic recurrent varicose veins who was treated with endovenous laser ablation and transluminal occlusion of perforator with attempted phlebectomies for extensive varices. The phlebectomies turned out to be near impossible due to friability of the veins. Her treatment was completed with post-operative ultrasound guided foam sclerotherapy seven months later. She was subsequently diagnosed as Ehlers Danlos syndrome type IV. A duplex ultrasound scan 18 months post-endovenous laser ablation and transluminal occlusion of perforator and 11 months after ultrasound guided foam sclerotherapy confirmed successful closure with virtual atrophy of all treated veins. She was found to be reflux free and only showed a few scattered cosmetic reticular veins. Open varicose vein surgery has been reported as being hazardous in the past in a patient with Ehlers Danlos syndrome type IV. Our experience has shown that endovenous laser ablation, transluminal occlusion of perforator and ultrasound guided foam sclerotherapy appear to be effective in treating this patient with Ehlers Danlos syndrome type IV, although phlebectomies were technically impossible.

https://doi.org/10.1177/0268355514531412

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August 2015
14 Reads

Endovenous surgery for recurrent varicose veins with a one-year follow up in a patient with Ehlers Danlos syndrome type IV.

Phlebology 2015 Aug 8;30(7):489-91. Epub 2014 Apr 8.

The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey, UK.

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http://dx.doi.org/10.1177/0268355514531412DOI Listing
August 2015
17 Reads
1.920 Impact Factor

The effects of environmental and compositional manipulations on the longevity of Tessari-made foam for sclerotherapy.

Journal of vascular surgery. Venous and lymphatic disorders

Tessari-made foam sclerotherapy is performed around the world in a variety of clinics differing in methods, equipment, temperatures, and altitudes. We investigated how the following factors affected the foam's longevity: silicone vs nonsilicone syringes, volume of foam made, ratio of gas to sclerosant, use of air vs 50:50 mixture of carbon dioxide and oxygen, temperature, altitude, and 10 consecutive reuses of the syringes.Sclerosant foam was made by the Tessari double-syringe technique. To calculate the longevity, the time was taken for half of the original volume of sclerosant to settle. Half-lives were compared with use of silicone and silicone-free syringes to make the foam. We investigated how the volume (5 mL vs 2 mL) and different ratios affected the foam by observing the half-life of 4:1, 3.5:1, and 3:1 ratios of gas to sclerosant. Air and a 50:50 mixture of carbon dioxide and oxygen were both used as the gas in changing the ratio and volume to see which produced better foam. These experiments were conducted at room (23.9°C) and refrigerator (3°C) temperatures with a constant pressure. The different ratio, volume, and silicone vs nonsilicone syringe experiments were all repeated at 9314, 7460, 4575, and 2326 feet above sea level in addition to the baseline experiment, which took place at 236 feet above sea level. To test how consecutive uses of syringes affected the foam, we made consecutive batches of foam reusing each pair of syringes 10 times; this was repeated five times with silicone syringes and twice with nonsilicone syringes.Switching to nonsilicone syringes can increase longevity by 70%. A larger volume of foam and a 3:1 ratio produced longer half-lives at all temperatures and altitudes. The lower (3°C) temperature increased the longevity of foam in all instances, as did the use of air. A high altitude (low pressure) had a detrimental effect on the foam's longevity. Ten consecutive syringe uses had no significant impact on the foam's half-life (silicone syringe mean between first five and last five uses, P = .95).The optimum conditions for making foam are nonsilicone syringes, larger volumes, a 3:1 air to sclerosant ratio, and low temperatures. Silicone syringes can be reused until friction becomes a burden. Temperature has a bigger effect than altitude on longevity of the foam. Making foam in larger volumes would allow the foam to last longer. To compensate for high altitudes (low pressures), decreasing the temperature will increase the foam's longevity.

https://doi.org/10.1016/j.jvsv.2014.07.010

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July 2015
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The effects of environmental and compositional manipulations on the longevity of Tessari-made foam for sclerotherapy.

J Vasc Surg Venous Lymphat Disord 2015 Jul 4;3(3):312-8. Epub 2014 Sep 4.

Whiteley Clinic, Guildford, Surrey, United Kingdom; Faculty of Health and Biomedical Sciences, University of Surrey, Guildford, Surrey, United Kingdom. Electronic address:

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http://dx.doi.org/10.1016/j.jvsv.2014.07.010DOI Listing
July 2015
13 Reads
1 Citation

Long-term results of transjugular coil embolisation for pelvic vein reflux - Results of the abolition of venous reflux at 6-8 years.

Phlebology

Pelvic venous reflux is known to be associated with lower limb varicose veins in 20% of women with a history of at least one previous vaginal delivery. Pelvic vein embolisation with coils has been shown to be a successful treatment in the short term. The objective of this study was to ascertain the long-term outcomes of pelvic vein embolisation for pelvic venous reflux.Patients who had undergone pelvic vein embolisation in 2005-2007 were invited back to a specialist vein unit for transvaginal duplex ultrasonography in the summer of 2013. A total of 110 women were contacted. Pre-embolisation transvaginal duplex ultrasonography results were compared to those obtained six weeks post-procedure and at long-term follow-up.Twenty-eight female patients aged 40 to 75 years (mean 53.5) attended (response rate 25.5%), with parity prior to embolisation ranging from 1-5 children (mean 2.8). Mean follow-up time was 7.5 years. Six weeks post-procedure, 25 women had complete or virtual elimination of all reflux, and three had persistent reflux in at least one vein. At long-term follow-up, 11 women had complete elimination of all reflux, seven had elimination of all truncal reflux but minor reflux in vulval veins, six had minor reflux in one truncal vein, and four had significant reflux in one or more truncal veins (one of these gave birth one-year post-pelvic vein embolisation and another had coils removed during gynaecological surgery).Transjugular pelvic vein embolisation is a durable technique for the abolition of reflux in the pelvic veins and is particularly adept at treating reflux in the ovarian veins.

https://doi.org/10.1177/0268355515591306

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July 2015
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A thematic analysis of experiences of varicose veins and minimally invasive surgery under local anaesthesia.

Journal of clinical nursing

To gain insight into the experience of living with varicose veins and undergoing minimally invasive surgery under local anaesthesia in a private clinic.Minimally invasive surgery under local anaesthesia is replacing traditional surgical stripping for the treatment for varicose veins. Conscious surgery has previously been associated with elevated levels of anxiety and some associated pain. There is limited research exploring the experiences of patients undergoing varicose vein surgery under local anaesthesia.Qualitative semi-structured interviews with 20 patients who took part in a mixed methods study exploring the effects of distraction on intra-operative pain and anxiety.Participants were interviewed eight weeks post surgery about their experiences before, during and after surgery. Interviews were analysed using thematic analysis.Four themes were captured (1) negative emotions associated with symptoms, (2) unpreparedness for the surgical process, (3) feeling cared for and (4) improvements in well-being. An overarching theme of relationships was identified. Overall, varicose veins had a detrimental impact on quality of life prior to surgery. Patients felt unprepared for their procedure and experienced the operation as anxiety provoking and uncomfortable. This was much helped by the support of nursing staff in the theatre. Post surgery, patients' quality of life was reported as improved.More emphasis needs to be placed on preparing patients for surgery under local anaesthesia. The role of the nurse is central to creating a caring, relaxed environment which could improve patient experience.Patients' experiences of varicose veins and their treatment both influence, and are influenced by relationships with others at all stages of the management process. Nurses play an important role in improving patient experience during surgery and care needs to be taken to ensure that patients understand and accept the processes of surgery and recovery.

https://doi.org/10.1111/jocn.12719

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July 2015
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A thematic analysis of experiences of varicose veins and minimally invasive surgery under local anaesthesia.

J Clin Nurs 2015 Jun 8;24(11-12):1502-12. Epub 2015 Jan 8.

The Whiteley Clinic, Stirling House, Guildford, Surrey.

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http://dx.doi.org/10.1111/jocn.12719DOI Listing
June 2015
4 Reads
1.233 Impact Factor

The comparative impact of conservative treatment versus superficial venous surgery, for the treatment of venous leg ulcers: A systematic review of the impact on patients' quality of life.

Phlebology

Leg ulcers are known to have a profound effect on patients' quality of life; however, the influence of different treatment approaches is unclear. This review aims to evaluate the comparative impact of conservative treatments and superficial venous surgery, for venous leg ulcers, on patients' Quality of Life.Three electronic databases (PsycInfo, Medline and CINAHL), and reference lists of relevant articles, were searched. A total of 209 articles were initially identified, and 16 articles were included in the review.The results lend cautious support to the suggestion that all treatments have a positive effect on quality of life, regardless of type, whilst wound status also appears to be an important factor.Some evidence suggests that surgical treatment methods may lead to greater improvements in patients' quality of life than compression bandaging alone; however, future research may focus on the psychological mechanisms underlying such changes.

https://doi.org/10.1177/0268355515581278

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May 2015
8 Reads

Arterial false aneurysm in the groin following endovenous laser ablation.

Phlebology

Endovenous laser ablation is a minimally invasive catheter-based procedure for the treatment of varicose veins. The procedure involves injecting tumescent anaesthesia around the catheterised truncal vein, before thermal ablation by the laser. We report a case of a false aneurysm arising from a branch of the inferior epigastric artery, following endovenous laser ablation. The false aneurysm was thought to be caused by injury to the artery by the needle used to inject the tumescent anaesthesia. Although a rare complication, newer tumescentless techniques such as mechanicochemical ablation and cyanoacrylate glue would prevent such a complication.

https://doi.org/10.1177/0268355513512826

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May 2015
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Arterial false aneurysm in the groin following endovenous laser ablation.

Phlebology 2015 Apr 19;30(3):220-2. Epub 2013 Nov 19.

The Whiteley Clinic, Surrey, UK Faculty of Health and Biomedical Sciences, University of Surrey, Surrey, UK

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http://dx.doi.org/10.1177/0268355513512826DOI Listing
April 2015
21 Reads
1.920 Impact Factor

Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux.

Phlebology

To determine the prevalence of haemorrhoids in women with pelvic vein reflux, identify which pelvic veins are associated with haemorrhoids and assess if extent of pelvic vein reflux influences the prevalence of haemorrhoids.Females presenting with leg varicose veins undergo duplex ultrasonography to assess all sources of venous reflux. Those with significant reflux arising from the pelvis are offered transvaginal duplex ultrasound (TVS) to evaluate reflux in the ovarian veins and internal Iliac veins and associated pelvic varices in the adnexa, vulvar/labial veins and haemorrhoids. Patterns and severity of reflux were evaluated.Between January 2010 and December 2012, 419 female patients with leg or vulvar varicose vein patterns arising from the pelvis underwent TVS. Haemorrhoids were identified on TVS via direct tributaries from the internal Iliac veins in 152/419 patients (36.3%) and absent in 267/419 (63.7%). The prevalence of the condition increased with the number of pelvic trunks involved.There is a strong association between haemorrhoids and internal Iliac vein reflux. Untreated reflux may be a cause of subsequent symptomatic haemorrhoids. Treatment with methods proven to work in conditions caused by pelvic vein incompetence, such as pelvic vein embolisation and foam sclerotherapy, could be considered.

https://doi.org/10.1177/0268355514531952

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March 2015
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Evaluating the success of Nd: YAG laser ablation in the treatment of recalcitrant verruca plantaris and a cautionary note about local anaesthesia on the plantar aspect of the foot.

Journal of the European Academy of Dermatology and Venereology : JEADV

There are various methods advocated for the treatment of verruca plantaris. However, many verrucas do not respond to simple treatment.This study presents our results using Nd: YAG laser ablation therapy for such recalcitrant cases.We performed a retrospective audit by sending a questionnaire to all patients with recalcitrant verrucas who had been treated with Nd:YAG laser ablation over the previous 12 months. The questionnaire asked whether treatment had been successful, successful but new lesions had emerged, partially successful with improvement or unsuccessful. A Fontana Nd:YAG laser was used at the following specifications; long pulsed mode with pulse width 25 ms, frequency 1.0 Hz; fluence 240 J/cm(2) and spot size 2 mm. Some patients requested local anaesthesia and had direct infiltration with 0.5% plain lidocaine.Fifty-three of the original 87 patients responded (60.9% response rate) with a male to female ratio of 24:29, mean age of 47 years and an age range between 22-72. Thirty-seven patients reported complete success post treatment (69.8%) and a further five reported improvement. The remaining 11 felt their treatment was unsuccessful. The cure rate was 81.8% in unilateral single cases, 68.1% in unilateral multiple cases and 65% in bilateral cases. Ten patients requested sublesional lidocaine injections of which 4 had skin breakdown after Nd: YAG ablation.Nd:YAG laser ablation is effective in the treatment of recalcitrant verruca plantaris. However, we caution against the use of direct local anaesthesia infiltration before laser treatment.

https://doi.org/10.1111/jdv.12579

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March 2015
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Evaluating the success of Nd: YAG laser ablation in the treatment of recalcitrant verruca plantaris and a cautionary note about local anaesthesia on the plantar aspect of the foot.

J Eur Acad Dermatol Venereol 2015 Mar 9;29(3):463-7. Epub 2014 Jun 9.

Chiropodist and Podiatrist at the Whiteley Clinic, Guildford, UK.

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http://dx.doi.org/10.1111/jdv.12579DOI Listing
March 2015
6 Reads
2.830 Impact Factor

Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux.

Phlebology 2015 Mar 22;30(2):133-9. Epub 2014 Apr 22.

The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey, UK Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK

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http://dx.doi.org/10.1177/0268355514531952DOI Listing
March 2015
7 Reads
2 Citations
1.920 Impact Factor

An in vitro study to optimise treatment of varicose veins with radiofrequency-induced thermo therapy.

Phlebology

To develop a reproducible method of using radiofrequency-induced thermotherapy with adequate thermal spread to ablate the whole vein wall in a truncal vein but avoiding carbonisation, device sticking and high impedance "cut outs" reducing interruptions during endovenous treatments.Porcine liver was treated with radiofrequency-induced thermotherapy under glass to allow measurements, observation and video recording. Powers of 6-20 W were used at varying pullback speeds to achieve linear endovenous energy densities of 18-100 J/cm. Thermal spread, carbonisation of treated tissue and high-impedance cut outs were recorded.The currently recommended power settings of 18 and 20 W produced sub-optimal results. If pulled back at 3 s/cm to achieve linear endovenous energy densities around 60 J/cm, tissue carbonisation and high impedance cut outs occurred. When high powers and fast pullbacks of 1 s/cm were used, no carbonisation or cut outs occurred but thermal ablation of the liver model was below target due to reduced time for thermal conduction. Low powers (6-12 W) with slow pullbacks (6-12 s/cm) achieved target thermal ablation with minimal carbonisation and high impedance cut outs.Using low power (6 W) and a slow discontinuous pullback (6 s every 0.5 cm, in steps), we were able to achieve our target thermal ablation in the porcine liver model without carbonisation and high impedance cut outs. This suggests the currently recommended power levels could be reduced, reducing the need to remove the device to clean the electrodes during treatment while achieving target thermoablation of the treated tissue.

https://doi.org/10.1177/0268355514552005

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March 2015
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An in vitro study to optimise treatment of varicose veins with radiofrequency-induced thermo therapy.

Phlebology 2015 Feb 12;30(1):17-23. Epub 2014 Sep 12.

The Whiteley Clinic, Guildford, Surrey, UK Faculty of Health and Biomedical Sciences, University of Surrey, Guildford, Surrey, UK

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http://dx.doi.org/10.1177/0268355514552005DOI Listing
February 2015
53 Reads
1 Citation
1.920 Impact Factor

The European multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins.

Journal of vascular surgery. Venous and lymphatic disorders

Cyanoacrylate (CA) embolization of refluxing great saphenous veins (GSVs) has been previously described. The outcomes from a multicenter study are still lacking.A prospective multicenter study was conducted in seven centers in four European countries to abolish GSV reflux by endovenous CA embolization. Neither tumescent anesthesia nor postinterventional compression stockings were used. Varicose tributaries remained untreated until at least 3 months after the index treatment. Clinical examination, quality of life assessment, and duplex ultrasound evaluation were performed at 2 days and after 1, 3, 6, and 12 months.In 70 patients, of whom 68 (97.1%) were available for 12-month follow-up, 70 GSVs were treated. Two-day follow-up showed one proximal and one distal partial recanalization. Three additional proximal recanalizations were observed at 3-month (n = 2) and 6-month (n = 1) follow-up. Cumulative 12-month survival free from recanalization was 92.9% (95% confidence interval, 87.0%-99.1%). Mean (standard deviation) Venous Clinical Severity Score improved from 4.3 ± 2.3 at baseline to 1.1 ± 1.3 at 12 months. Aberdeen Varicose Vein Questionnaire score showed an improvement from 16.3 at baseline to 6.7 at 12 months (P < .0001). Side effects were generally mild; a phlebitic reaction occurred in eight cases (11.4%) with a median duration of 6.5 days (range, 2-12 days). Pain without a phlebitic reaction was observed in five patients (8.6%) for a median duration of 1 day (range, 0 -12 days). No serious adverse event occurred. Paresthesia was not observed.Endovenous CA embolization of refluxing GSVs is safe and effective without the use of tumescent anesthesia or compression stockings.

https://doi.org/10.1016/j.jvsv.2014.09.001

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January 2015
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Ovarian Vein Diameter Cannot Be Used as an Indicator of Ovarian Venous Reflux.

European Journal of Vascular and Endovascular Surgery

OBJECTIVES: Previous research into pelvic venous reflux has suggested that the size of the ovarian veins indicates the presence or absence of reflux. It is already known that vessel diameter is not an indicator of reflux in the great saphenous vein. However, to this day, physicians still use vein size to plan treatment of refluxing ovarian veins. The authors aimed to investigate whether or not vessel diameter can be used as an indicator of reflux in the ovarian veins. METHODS: Nineteen female patients (mean 40.2 years, range 29-60) presenting to a specialist vein unit with leg varicose veins underwent duplex ultrasonography (DUS). All were found to have a significant pelvic contribution to their leg reflux on transvaginal duplex ultrasonography (TVS) and were referred to an interventional radiologist for treatment by transjugular coil embolization. During the procedure, the diameter of the ovarian veins was measured using digital subtraction venography. RESULTS: Thirty-four ovarian veins were measured (17 right, 17 left) and of these 18 were found to be non-refluxing while 16 displayed reflux. The mean diameter of the non-refluxing veins was 7.2 mm (range 3-13 mm)and that of the refluxing veins was 8.5 mm (range 4-13 mm). This difference was found to be insignificant at a 95% confidence level (Student t test, p = .204). CONCLUSIONS: There is no significant difference between the diameters of competent and refluxing ovarian veins and, as such, techniques that measure vein diameter may not be suitable for the diagnosis of venous reflux in the ovarian veins.

https://doi.org/10.1016/j.ejvs.2014.10.013

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January 2015
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Histologic findings after mechanochemical ablation in a caprine model with use of ClariVein.

Journal of vascular surgery. Venous and lymphatic disorders

The use of foam and liquid sclerotherapy for the treatment of varicose veins and underlying venous reflux is widespread. A novel device, the ClariVein Occlusion Catheter (Vascular Insights LLC, Madison, Conn), has been the subject of several clinical trials in humans. We report the initial histologic results obtained with use of the device in a caprine vein model.A total of 11 male goats (12 veins) underwent minimally invasive procedures. Unilateral mechanochemical ablation of the lateral saphenous vein by the ClariVein Occlusion Catheter with an E-140° tip was performed under fluoroscopic guidance in five veins with 5 mL of 1.5% sodium tetradecyl sulfate (STS) and in one vein with 5 mL of 0.9% saline. The remaining six received injection sclerotherapy with 5 mL of 1.5% STS or 0.9% saline. All subjects were assessed with ultrasound before the procedure and intermittently afterward during a period of 12 weeks. Subsequent termination was immediately followed by necropsy and histologic examination of the treated veins.Complete occlusion of the lateral saphenous vein was observed in all subjects treated with ClariVein and STS, whereas complete patency was noted in all other treatment modalities. Histologic staining with hematoxylin and eosin and Masson trichrome stain revealed total fibrotic sealing with extensive collagen production in all ClariVein/STS veins. A statistical significance was observed in the difference in the number of occluded veins between subjects treated with ClariVein/STS and those treated by injection sclerotherapy (Fisher exact test, P < .01).The ClariVein Occlusion Catheter with 1.5% STS can be used to achieve complete mechanochemical ablation of the lateral saphenous vein in a caprine model. The evidence in this report can be used to justify the device's use for the treatment of the great saphenous vein in subsequent human clinical trials.

https://doi.org/10.1016/j.jvsv.2014.07.002

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January 2015
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The European multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins.

J Vasc Surg Venous Lymphat Disord 2015 Jan 18;3(1):2-7. Epub 2014 Oct 18.

Imperial College London, London, United Kingdom.

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http://dx.doi.org/10.1016/j.jvsv.2014.09.001DOI Listing
January 2015
22 Reads
3 Citations

Ovarian Vein Diameter Cannot Be Used as an Indicator of Ovarian Venous Reflux.

Eur J Vasc Endovasc Surg 2015 Jan;49(1):90-4

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http://dx.doi.org/10.1016/j.ejvs.2014.10.013DOI Listing
January 2015
10 Reads
4 Citations
2.490 Impact Factor

Histologic findings after mechanochemical ablation in a caprine model with use of ClariVein.

J Vasc Surg Venous Lymphat Disord 2015 Jan 20;3(1):81-5. Epub 2014 Aug 20.

Whiteley Clinic, Guildford, Surrey, United Kingdom; Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom. Electronic address:

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http://dx.doi.org/10.1016/j.jvsv.2014.07.002DOI Listing
January 2015
7 Reads

Endovenous radiofrequency ablation and combined foam sclerotherapy treatment of multiple refluxing perforator veins in a Klippel-Trenaunay syndrome patient.

Phlebology

We describe an unusual pattern of venous abnormality and the use of endovenous radiofrequency ablation, using the TRans-Luminal Occlusion of Perforator technique to treat multiple refluxing perforators in a 29-year-old patient with Klippel-Trenaunay syndrome. Klippel-Trenaunay syndrome is a rare congenital anomaly characterised by a triad of features including unilateral limb overgrowth, venous varicosities and capillary malformations of the affected limb. Ultrasound findings demonstrated 22 incompetent perforator veins in the lateral aspect of the patients left leg, communicating with a complex network of large calibre varicosities causing unilateral leg oedema and pain. Staged radiofrequency ablation procedures using the Olympus Celon RFITT (radiofrequency-induced thermotherapy; please see Technical Note) device under local anaesthetic were performed. These procedures were followed with two sessions of foam sclerotherapy. This case report describes the efficacy of this treatment regime and this patient's significantly improved morbidity 18 months after initial treatment.

https://doi.org/10.1177/0268355513496991

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2014
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Endovenous radiofrequency ablation and combined foam sclerotherapy treatment of multiple refluxing perforator veins in a Klippel-Trenaunay syndrome patient.

Phlebology 2014 Dec 18;29(10):698-700. Epub 2013 Jul 18.

The Whiteley Clinic, Guildford, Surrey, UK.

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http://dx.doi.org/10.1177/0268355513496991DOI Listing
December 2014
7 Reads
1.920 Impact Factor

Primary avalvular varicose anomalies are a naturally occurring phenomenon that might be misdiagnosed as neovascular tissue in recurrent varicose veins.

Journal of vascular surgery. Venous and lymphatic disorders

The objective of this study was to report a phenomenon in patients with primary varicose veins that resembles neovascular tissue in postsurgical recurrences-primary avalvular varicose anomalies (PAVA).Between March 2012 and July 2013, 756 patients (122 men, 634 women) with primary varicose veins (mean age, 53 years; range, 18-89 years) underwent duplex ultrasonography with retrospective analysis of their reflux patterns. We diagnose PAVA as small, refluxing vessels in legs with primary varicose veins and no history of surgery, trauma, or infection in the area that show one or more of three patterns of distribution: lymph node pattern-PAVA arising directly from groin lymph nodes; peritruncal pattern-PAVA wrapping around the great, small, or anterior accessory saphenous veins; and atypical pattern. PAVA are predominantly found within the saphenous fascia, but components have been found to emerge into the superficial and deep venous compartments.We analyzed results from 1398 legs (756 patients). Sixty-four legs (4.6%) in 58 patients exhibited PAVA, bilateral in six patients and unilateral in 52 patients. Lymph node involvement and peritruncal PAVA were seen in 23.4% and 70.3% of legs, respectively. The small saphenous vein was the most common truncal vein to be involved (48.9% of peritruncal cases). More than one pattern of PAVA could be observed in seven legs. Of the 48 women with PAVA, 42% had concurrent pelvic vein reflux.Neovascularization has been identified as a major cause of clinically recurrent varicose veins. Neovascular tissue has been described after endovenous thermoablation. We suggest that this might represent PAVA undetected preoperatively in some cases. PAVA are thin-walled, serpiginous, incompetent vessels that resemble neovascular tissue. We conclude that neovascularization should be diagnosed as a source of recurrence after endovenous surgery only if PAVA had been actively looked for, and excluded, in the preoperative diagnostic duplex ultrasound examination.

https://doi.org/10.1016/j.jvsv.2014.05.003

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October 2014
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Primary avalvular varicose anomalies are a naturally occurring phenomenon that might be misdiagnosed as neovascular tissue in recurrent varicose veins.

J Vasc Surg Venous Lymphat Disord 2014 Oct 25;2(4):390-6. Epub 2014 Jun 25.

Whiteley Clinic, Guildford, Surrey, United Kingdom; Faculty of Health and Biomedical Sciences, University of Surrey, Guildford, Surrey, United Kingdom. Electronic address:

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http://dx.doi.org/10.1016/j.jvsv.2014.05.003DOI Listing
October 2014
3 Reads
1 Citation

Pelvic venous reflux is a major contributory cause of recurrent varicose veins in more than a quarter of women.

J Vasc Surg Venous Lymphat Disord 2014 Oct 24;2(4):411-5. Epub 2014 Jun 24.

Whiteley Clinic, Guildford, Guildford, Surrey, United Kingdom; University of Surrey, Faculty of Health and Medical Sciences, Guildford, Surrey, United Kingdom. Electronic address:

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http://dx.doi.org/10.1016/j.jvsv.2014.05.005DOI Listing
October 2014
11 Reads
3 Citations

Debate: whether venous perforator surgery reduces recurrences.

Journal of vascular surgery

Superficial venous surgery and perforator vein surgery, specifically, have a long and varied history in the evolution of vascular surgery, especially because venous disease continues to be extremely common. As with other areas of our specialty, perforator vein procedures have progressed from being purely open operations to becoming less invasive procedures. Despite this, there remains much discussion (as well as overt disagreement) about whether perforator vein surgery is actually appropriate and beneficial in the first place. Surgeons have no level I evidence from randomized controlled studies to determine whether perforator vein surgery does or does not reduce the chances of recurrence of superficial venous varicosities, so we must rely on the evidence as it currently is. Perhaps not surprisingly, our two experts have assembled divergent opinions on the role of perforator venous surgery in contemporary practice.

https://doi.org/10.1016/j.jvs.2014.06.102

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October 2014
8 Reads

Debate: whether venous perforator surgery reduces recurrences.

J Vasc Surg 2014 Sep;60(3):796-803

The Cardiovascular Center, Tufts Medical Center, Boston, Mass. Electronic address:

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http://dx.doi.org/10.1016/j.jvs.2014.06.102DOI Listing
September 2014
8 Reads
2 Citations
3.021 Impact Factor

Part one: for the motion. Venous perforator surgery is proven and does reduce recurrences.

Authors:
M S Whiteley

Eur J Vasc Endovasc Surg 2014 Sep;48(3):239-42

The Whiteley Clinic, Guildford and London, UK; Faculty of Health and Biomedical Sciences, University of Surrey, Guildford, UK. Electronic address:

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http://dx.doi.org/10.1016/j.ejvs.2014.06.044DOI Listing
September 2014
1 Read
2.490 Impact Factor

Twelve-Month Follow-up of the European Multicenter Study on Cyanoacrylate Embolization of Incompetent Great Saphenous Veins.

J Vasc Surg Venous Lymphat Disord 2014 Jan 12;2(1):105-6. Epub 2013 Dec 12.

Imperial College, London, United Kingdom.

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http://dx.doi.org/10.1016/j.jvsv.2013.10.009DOI Listing
January 2014
1 Read

Healing rates following venous surgery for chronic venous leg ulcers in an independent specialist vein unit.

Phlebology

This is a retrospective study over 12 years reporting the healing rates of leg ulcers at a specialist vein unit. All patients presented with active chronic venous leg ulcers (clinical,aetiological, anatomical and pathological elements [CEAP]: C6) and had previously been advised elsewhere that their ulcers were amenable to conservative measures only.Seventy-two patients (84 limbs) were treated between March 1999 and June 2011. Patients were contacted in August 2011 by questionnaire and telephone. Of 72 patients,two were deceased and two had moved location at follow-up, so were not contactable. Fifty patients replied and 18 did not (response rate 74%), representing a mean follow-uptime of 3.1 years.Ulcer healing occurred in 85% (44 of 52 limbs) of which 52% (27) limbs were no longer confined to compression. Clinical improvement was achieved in 98% of limbs.This study shows that a significant proportion of ulcers currently managed conservatively can be healed by surgical intervention.

https://doi.org/10.1258/phleb.2012.011097

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May 2013
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Healing rates following venous surgery for chronic venous leg ulcers in an independent specialist vein unit.

Phlebology 2013 Apr;28(3):132-9

The Whiteley Clinic, Stirling House, Guildford, Surrey, UK.

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http://dx.doi.org/10.1258/phleb.2012.011097DOI Listing
April 2013
2 Reads
3 Citations
1.920 Impact Factor

Pelvic Venous Reflux is a Major Contributory Cause of Recurrent Varicose Veins in more than a Quarter of Women.

J Vasc Surg Venous Lymphat Disord 2013 Jan 8;1(1):100-1. Epub 2012 Dec 8.

The Whiteley Clinic, Guildford, United Kingdom.

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http://dx.doi.org/10.1016/j.jvsv.2012.10.007DOI Listing
January 2013
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The European Multicenter Study on Cyanoacrylate Embolization of Refluxing Great Saphenous Veins without Tumescent Anesthesia and without Compression Therapy.

J Vasc Surg Venous Lymphat Disord 2013 Jan 8;1(1):101. Epub 2012 Dec 8.

Imperial College, London, United Kingdom.

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http://dx.doi.org/10.1016/j.jvsv.2012.10.010DOI Listing
January 2013
3 Reads

Letter regarding: 'The role of perforators in chronic venous insufficiency' by TF O'Donnell. Phlebology 2010;25:3-10.

Authors:
M S Whiteley

Phlebology 2010 Dec;25(6):314; author reply 315-6

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http://dx.doi.org/10.1258/phleb.2010.010013DOI Listing
December 2010
1 Read
1.920 Impact Factor

Deep vein thrombosis (DVT) after venous thermoablation techniques: rates of endovenous heat-induced thrombosis (EHIT) and classical DVT after radiofrequency and endovenous laser ablation in a single centre.

European Journal of Vascular and Endovascular Surgery

INTRODUCTION: Deep vein thrombosis (DVT) after varicose vein surgery is well recognised. Less well documented is endovenous heat-induced thrombosis (EHIT), thrombus extension into a deep vein after superficial venous thermoablation. We examined the rates of DVT in our unit after radiofrequency (RFA) and endovenous laser ablation (EVLA) with specific attention to thrombus type. METHOD: Retrospective analysis of all cases of RFA under general anaesthesia and EVLA under local anaesthesia was performed. Cases of DVT were identified from the unit database and analysed for procedural details. RESULTS: In total, 2470 cases of RFA and 350 of EVLA were performed. Post-RFA, DVT was identified in 17 limbs (0.7%); 4 were EHIT (0.2%). Concomitant small saphenous vein (SSV) ligation and stripping was a risk factor for calf-DVT (OR 3.4, 95%CI 1.2-9.7, P=0.036), possibly due to an older patient group with more severe disease. Post-EVLA, 4 DVTs were identified (1%), of which 3 were EHIT (0.9%). CONCLUSION: The DVT rate including EHIT was similar in patients treated with RFA and EVLA and was low. Routine post-operative duplex ultrasound scanning is recommended until the significance of EHIT is better understood, in accordance with consensus guidelines. DVT rates for both techniques compare favourably with those published for saphenous vein stripping.

https://doi.org/10.1016/j.ejvs.2010.05.011

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October 2010
6 Reads

Deep vein thrombosis (DVT) after venous thermoablation techniques: rates of endovenous heat-induced thrombosis (EHIT) and classical DVT after radiofrequency and endovenous laser ablation in a single centre.

Eur J Vasc Endovasc Surg 2010 Oct 23;40(4):521-7. Epub 2010 Jul 23.

The Whiteley Clinic, 1 Stirling House, Stirling Road, Guildford GU2 7RF, UK.

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http://dx.doi.org/10.1016/j.ejvs.2010.05.011DOI Listing
October 2010
114 Reads
17 Citations
2.490 Impact Factor

One-year outcomes of radiofrequency ablation of incompetent perforator veins using the radiofrequency stylet device.

Phlebology

Early success treating incompetent perforator veins (IPVs) with radiofrequency ablation (RFA) and the trend to move varicose vein surgery into a walk-in walk-out service led to the design of a specific device enabling RFA of IPVs using local anaesthesia (ClosureRFS stylet). Our aim was to assess one-year outcomes of a clinical series of patients undergoing treatment with this device. Truncal reflux, where present, was treated initially, and RFA of IPVs was performed as a secondary procedure.Duplex ultrasound examinations were performed and the presence of IPVs documented. Results were compared with preoperative scans. IPVs were classified as closed, not closed/reopened or de novo.Of the 75 patients invited for follow-up, 53 attended at a median time of 14 months (range 11-25). Sixty-seven limbs were analysed (M:F 1:2.1, median age 62, range 25-81). Of the 124 treated IPVs, 101 were closed (82%). Clinical, aetiological, anatomical and pathological clinical score was improved in 49.3% limbs. IPV closure was reduced in patients with recurrent varicose veins compared with primary varicose veins (72.3% versus 87%, P = 0.056).These results demonstrate the radiofrequency stylet device to be an effective treatment for IPVs.

https://doi.org/10.1258/phleb.2009.008084

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May 2010
4 Reads

One-year outcomes of radiofrequency ablation of incompetent perforator veins using the radiofrequency stylet device.

Phlebology 2010 Apr;25(2):79-84

The Whiteley Clinic, 1 Stirling House, Stirling Road, Guildford, GU2 7RF, UK.

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http://dx.doi.org/10.1258/phleb.2009.008084DOI Listing
April 2010
8 Reads
1.920 Impact Factor

Pelvic vein reflux in female patients with varicose veins: comparison of incidence between a specialist private vein clinic and the vascular department of a National Health Service District General Hospital.

Phlebology

Mounting evidence suggests that pelvic vein reflux is an important contributing factor to recurrent varicose veins. We compared the incidence in our specialist private unit (Unit A) with that of a District General Hospital (Unit B).Results of all female patient lower limb duplex ultrasound (LLDUS) and transvaginal pelvic ultrasound (TVUS) scans performed over a one-year period were retrospectively reviewed. Patients with refluxing veins emanating from the abdomen or pelvis on LLDUS (non-saphenous reflux) routinely proceeded to TVUS in Unit A.In Unit A, non-saphenous reflux on LLDUS was present in 90-462 female patients (19.5%). In 81.1% of these, TVUS confirmed reflux in truncal pelvic veins (incidence 15.8%). In Unit B, non-saphenous reflux was present in 60-279 female patients (21.5%).One in five women presenting with varicose veins have reflux of non-saphenous origin. This is the case in specialist and non-specialist units. One in six has associated pelvic vein reflux.

https://doi.org/10.1258/phleb.2008.008041

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July 2009
7 Reads

Pelvic vein reflux in female patients with varicose veins: comparison of incidence between a specialist private vein clinic and the vascular department of a National Health Service District General Hospital.

Phlebology 2009 Jun;24(3):108-13

The Whiteley Clinic, 1, Stirling House, Stirling Road, Guildford GU2 7RF, UK.

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http://dx.doi.org/10.1258/phleb.2008.008041DOI Listing
June 2009
3 Reads
3 Citations
1.920 Impact Factor

Five-year results of incompetent perforator vein closure using TRans-Luminal Occlusion of Perforator.

Phlebology

In 2000, we developed a percutaneous method of treating incompetent perforator veins (IPV) using ultrasound-guided radiofrequency ablation (RFA), which we termed TRansluminal Occlusion of Perforator (TRLOP).To audit the five-year outcome of the TRLOP technique as indicated by the rate of IPV closure on duplex ultrasound (DUS).Patients underwent DUS five years post-TRLOP. Experienced vascular technologists documented the presence of IPVs using a two co-ordinate system, blinded to previous results. Results were then compared with preoperative scans. IPVs were classified as: closed; not closed/reopened; or de novo. Closed IPVs were defined as the absence of any IPV at or within 5 cm of a previous IPV in the vertical and horizontal plane. Any IPVs found outside the delineated area were defined as de novo IPVs.Of 67 patients invited, 37 attended DUS (55% participation rate; men to women ratio of 14:23, age 40-84; mean 64). Preoperative clinical, aetiological, anatomical and pathological classification: C2, 36.2%; C3, 27.6%; C4, 34.5%; C6, 1.7%. From 125 IPVs analysed, 101 were closed (81%), 24 were not closed/reopened (19%) and 14 de novo IPVs were found.Despite these results representing our learning curve for the procedure, we found TRLOP to be an effective treatment for IPVs. The closure rates described are comparable with the published clinical series data for subfascial endoscopic perforator surgery.

https://doi.org/10.1258/phleb.2008.008016

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May 2009
4 Reads

Five-year results of incompetent perforator vein closure using TRans-Luminal Occlusion of Perforator.

Phlebology 2009 Apr;24(2):74-8

The Whiteley Clinic, Guildford GU2 7RF, UK.

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http://dx.doi.org/10.1258/phleb.2008.008016DOI Listing
April 2009
45 Reads
1.920 Impact Factor

Pelvic vein embolisation in the management of varicose veins.

Cardiovasc Intervent Radiol 2008 Nov-Dec;31(6):1159-64. Epub 2008 Aug 28.

Department of Radiology, St. George's Hospital, Blackshaw Road, London SW17 0QT, UK.

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http://dx.doi.org/10.1007/s00270-008-9402-9DOI Listing
March 2009
22 Reads
5 Citations
1.970 Impact Factor

Pelvic vein embolisation in the management of varicose veins.

Cardiovascular and interventional radiology

Pelvic vein incompetence is common in patients with atypical varicose veins, contributing to their recurrence after surgery. Therefore, refluxing pelvic veins should be identified and treated. We present our experience with pelvic vein embolisation in patients presenting with varicose veins. Patients presenting with varicose veins with a duplex-proven contribution from perivulval veins undergo transvaginal duplex sonography (TVUS) to identify refluxing pelvic veins. Those with positive scans undergo embolisation before surgical treatment of their lower limb varicose veins. A total of 218 women (mean age of 46.3 years) were treated. Parity was documented in the first 60 patients, of whom 47 (78.3%) were multiparous, 11 (18.3%) had had one previous pregnancy, and 2 (3.3%) were nulliparous. The left ovarian vein was embolised in 78%, the right internal iliac in 64.7%, the left internal iliac in 56.4%, and the right ovarian vein in 42.2% of patients. At follow-up TVUS, mild reflux only was seen in 16, marked persistent reflux in 6, and new reflux in 3 patients. These 9 women underwent successful repeat embolisation. Two patients experienced pulmonary embolisation of the coils, of whom 1 was asymptomatic and 1 was successfully retrieved; 1 patient had a misplaced coil protruding into the common femoral vein; and 1 patient had perineal thrombophlebitis. The results of our study showed that pelvic venous embolisation by way of a transjugular approach is a safe and effective technique in the treatment of pelvic vein reflux.

https://doi.org/10.1007/s00270-008-9402-9

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2008
7 Reads

Coil protruding into the common femoral vein following pelvic venous embolization.

Cardiovascular and interventional radiology

Pelvic venous embolization is performed for pelvic congestion syndrome and prior to lower limb varicose vein surgery in females with associated pelvic venous insufficiency. The procedure is analogous to varicocele embolization in males, although refluxing internal iliac vein tributaries may also be embolized. We report a case of inadvertent coil placement in the common femoral vein while embolizing the obturator vein, during pelvic vein embolization for recurrent lower limb varicose veins. There were no clinical consequences and the coil was left in situ. We advise caution when embolizing internal iliac vein tributaries where there is clinically significant communication with veins of the lower limb.

https://doi.org/10.1007/s00270-007-9249-5

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2008
7 Reads

It is possible to cause damage to a laser fibre during delivery of tumescent anaesthesia for endovenous laser ablation (EVLA).

European Journal of Vascular and Endovascular Surgery

AIMS: To establish a possible mechanism of damage to a laser fibre significant enough to cause a retained segment within a patient. METHODS: A 21 G needle was used to pierce a VARILASE 810 nm Laser Fibre inserted within a 4F sheath. A tiny pin source of light from the aiming beam emerged from the needle hole in the sheath. Using laser protection protocol, the generator was fired for one minute at 14 Watts (W) continuous wave. The sheath and fibre were then examined. In a control experiment, we were unable manually to break a fibre where the coating had been damaged prior to the laser being fired. RESULTS: The aiming beam was noted to be concentrated at the side of the catheter at the point of needle damage rather than at the fibre tip. When the fibre was removed from the sheath the distal length, from the point of damage to the tip, was retained within the sheath. Longer firing with the sheath surrounded by a wet towel or a pork loin resulted in complete severance of the sheath and fibre. CONCLUSION: There are no firm manufacturer's guidelines on whether Tumescent Anaesthesia should be delivered before or after the laser fibre has been inserted into the patient. Some units performing EVLA prefer to do this with the laser fibre in situ as it is easier to image on ultrasound than the sheath alone. The results of this in-vitro experiment would suggest it is possible to cause sufficient needle damage to fracture a laser fibre when fired. In the interests of safety we would recommend administration of tumescent anaesthesia should always be carried out before introduction of the laser fibre.

https://doi.org/10.1016/j.ejvs.2008.06.011

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October 2008
5 Reads

It is possible to cause damage to a laser fibre during delivery of tumescent anaesthesia for endovenous laser ablation (EVLA).

Eur J Vasc Endovasc Surg 2008 Oct;36(4):473-6

The Whiteley Clinic, Stirling House, Stirling Road, Guildford GU2 7RF, United Kingdom.

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http://dx.doi.org/10.1016/j.ejvs.2008.06.011DOI Listing
October 2008
1 Citation
2.490 Impact Factor

Coil protruding into the common femoral vein following pelvic venous embolization.

Cardiovasc Intervent Radiol 2008 Mar-Apr;31(2):435-8. Epub 2008 Jan 8.

The Whiteley Clinic, 1 Stirling House, Stirling Road, Guildford, GU2 7RF, UK.

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http://dx.doi.org/10.1007/s00270-007-9249-5DOI Listing
May 2008
6 Reads
1 Citation
1.970 Impact Factor

Randomized clinical trial of the effect of adding subfascial endoscopic perforator surgery to standard great saphenous vein stripping.

The British journal of surgery

BACKGROUND: This randomized trial was undertaken to investigate the fate of incompetent perforating veins (IPVs) following saphenofemoral ligation and stripping of the great saphenous vein (GSV), with or without subfascial endoscopic perforator surgery (SEPS). METHODS: Patients with venous reflux (greater than 0.5 s) of the GSV and additional IPVs were allocated randomly to standard surgery (saphenofemoral ligation, stripping and phlebectomies alone) or with the addition of SEPS. Patients with ulceration, recurrent veins, deep venous reflux/thrombosis or saphenopopliteal reflux were excluded. Duplex ultrasonography was carried out before operation, and at 1 week, 6 weeks, 6 months and 1 year after surgery. Quality of life questionnaires were completed and visual analogue scale scores collected at the same time points. RESULTS: Thirty-eight patients were allocated to SEPS and 34 to the no SEPS group. Two patients in the no SEPS group were excluded (one withdrew and the other had the wrong treatment). There were no differences between the two groups with respect to pain, mobility or quality of life scores during follow-up. A significantly higher proportion of patients in the no SEPS group had IPVs on duplex imaging at 1 year (25 of 32 versus 12 of 38; P < 0.001). CONCLUSION: IPVs do not remain closed following standard varicose vein surgery. The addition of SEPS was not associated with significant morbidity but did reduce the number of IPVs. Up to 1 year this had no effect on recurrence rates or quality of life, but late results remain to be seen. REGISTRATION NUMBER: ISRCTN18288048 (http://www.controlled-trials.com).

https://doi.org/10.1002/bjs.5945

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October 2007
4 Reads

Randomized clinical trial of the effect of adding subfascial endoscopic perforator surgery to standard great saphenous vein stripping.

Br J Surg 2007 Sep;94(9):1075-80

Department of Vascular Surgery, Royal Surrey County Hospital, Guildford, UK.

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http://dx.doi.org/10.1002/bjs.5945DOI Listing
September 2007
3 Reads
1 Citation
5.542 Impact Factor

Strip-track revascularization after stripping of the great saphenous vein.

The British journal of surgery

BACKGROUND: Varicose veins that recur after standard high tie and strip are often associated with venous reflux in the thigh, as shown by duplex ultrasonography. The aim of this study was to look for evidence of revascularization in the strip track after great saphenous vein (GSV) stripping. METHODS: A consecutive series of patients with duplex-proven great saphenous varicose veins underwent saphenofemoral ligation with intraoperative confirmation of successful stripping. Duplex ultrasonography was performed 1 week and 1 year after surgery. The presence and extent of haematoma was noted, as was any venous reflux within the strip track. RESULTS: At 1 year, four (6 per cent) of 70 patients had complete revascularization of the strip track and 12 (17 per cent) had partial revascularization, all with duplex-proven reflux. Partial revascularization was in the distal third of the track in six legs (9 per cent of the 70 patients), in the distal half in five (7 per cent) and was almost complete in one leg (1 per cent). All patients with revascularization had a significant strip-track haematoma at 1 week after surgery. CONCLUSION: Revascularization of the GSV strip track after stripping was found in 23 per cent of patients after 1 year; all of these had a postoperative haematoma in the track.

https://doi.org/10.1002/bjs.5598

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July 2007
5 Reads

Strip-track revascularization after stripping of the great saphenous vein.

Br J Surg 2007 Jul;94(7):840-3

Department of Vascular Surgery, Royal Surrey County Hospital, Guildford, UK.

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http://dx.doi.org/10.1002/bjs.5598DOI Listing
July 2007
1 Read
2 Citations
5.542 Impact Factor

Minimally invasive technique for ligation and stripping of the small saphenous vein guided by intra-operative duplex ultrasound.

Surgeon 2006 Dec;4(6):372-3, 375-7

The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey, GU2 7RF, UK.

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http://dx.doi.org/10.1016/s1479-666x(06)80113-7DOI Listing
December 2006
2.210 Impact Factor

Radiofrequency ablation (VNUS closure) does not cause neo-vascularisation at the groin at one year: results of a case controlled study.

Surgeon 2006 Apr;4(2):71-4

The Royal Surrey County Hospital, Guildford, UK.

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http://dx.doi.org/10.1016/s1479-666x(06)80032-6DOI Listing
April 2006
47 Reads
3 Citations
2.210 Impact Factor

Ultrasound changes at the saphenofemoral junction and in the long saphenous vein during the first year after VNUS closure.

Int Angiol 2002 Sep;21(3):272-4

Department of Vascular Surgery, Royal Surrey County Hospital, Guildford, UK.

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September 2002
1 Read
1 Citation
1.014 Impact Factor

A novel approach to the treatment of recurrent varicose veins.

Int Angiol 2002 Sep;21(3):275-6

Department of Vascular Surgery, Royal Surrey County Hospital, Guildford, UK.

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September 2002
6 Reads
1.014 Impact Factor

Clipping perforators without dividing them could reduce postoperative pain and swelling following subfascial endoscopic perforator surgery.

Ann R Coll Surg Engl 2002 May;84(3):210-1

Department of Vascular Surgery, Royal Surrey County Hospital, Guildford, UK.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503824PMC
May 2002
1 Read
1.223 Impact Factor

Incompetent perforating veins are associated with recurrent varicose veins.

European Journal of Vascular and Endovascular Surgery

AIMS: we suspected incompetent perforating veins of having a role in the development of recurrent varicose veins in some patients. The aim was to look for an association between perforators and recurrent varicose veins. METHODS: a consecutive group of patients presenting with varicose veins were examined using colour duplex ultrasonography by an experienced vascular technologist. Pathological perforating veins were defined as those exhibiting bi-directional flow and a diameter of 4 mm or greater at the fascia. RESULTS: between September 1998 and July 1999, 204 patients were examined. Primary varicose veins were found in 198 legs (135 patients) and recurrent varicose veins in 91 legs (69 patients). In patients with primary varicose veins, 88 (44%) had incompetent perforators compared to 57 (63%) of those with recurrent varicose veins (Chi-squared, p <0.005). Also, for recurrent varicose veins, the percentage of patients with any given number of incompetent perforators was higher than for primary varicose veins. Overall, there was a higher number of incompetent perforators in those with recurrent veins compared to primary veins and this difference was significant at 95% confidence interval. CONCLUSION: patients with recurrent varicose veins have both a higher prevalence and a greater number of incompetent perforating veins than patients with primary varicose veins.

https://doi.org/10.1053/ejvs.2001.1347

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May 2001
5 Reads

Incompetent perforating veins are associated with recurrent varicose veins.

Eur J Vasc Endovasc Surg 2001 May;21(5):458-60

Department of Vascular Surgery, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, UK.

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http://dx.doi.org/10.1053/ejvs.2001.1347DOI Listing
May 2001
2 Reads
2 Citations
2.490 Impact Factor

Inferior vena cava reconstruction using internal jugular vein.

Eur J Vasc Endovasc Surg 2001 Feb;21(2):185-6

Department of Vascular Surgery, The Royal Surrey County Hospital, Guildford, Surrey, UK.

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http://dx.doi.org/10.1053/ejvs.2001.1288DOI Listing
February 2001
8 Reads
1 Citation
2.490 Impact Factor

Maintenance of patency following remote superficial femoral artery endarterectomy.

Cardiovasc Surg 2000 Dec;8(7):533-7

Department of Surgery and Radiology, Royal Berkshire Hospital, London Road, Berks, Reading, UK.

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http://dx.doi.org/10.1016/s0967-2109(00)00072-7DOI Listing
December 2000
1 Read

Patient outcome alone does not justify the centralisation of vascular services.

Cook SJ, Rocker MD, Jarvis MR, Whiteley MS, Annals of the Royal College of Surgeons of England, 2000, vol. 82, no. 4, pp. 268-271, 2000

http://europepmc.org/abstract/med/10932662

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July 2000
6 Reads

Patient outcome alone does not justify the centralisation of vascular services.

Ann R Coll Surg Engl 2000 Jul;82(4):268-71

Department of Vascular Surgery, Royal Surrey County Hospital, Guildford, UK.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503500PMC
July 2000
4 Reads
1.223 Impact Factor

The 'morbidity and mortality' meeting--no longer defensible as surgical audit.

Ann R Coll Surg Engl 2000 May;82(5 Suppl):168

Royal Surrey County Hospital.

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May 2000
2 Reads
1.223 Impact Factor

Remote superficial femoral artery endarterectomy: medium-term results.

European Journal of Vascular and Endovascular Surgery

BACKGROUND: the aim of this study is to determine the medium-term results following successful remote superficial-femoral endarterectomy (RSFE). SETTING: district general hospital in United Kingdom. METHODS: RSFE comprises a single incision over the origin of the superficial femoral artery. The endarterectomy is carried out in a closed fashion from above. The cut end of distal atheroma is secured with a stent. Twenty-five limbs were followed up with three monthly duplex scans and angiography if any abnormality was suggested. All patients presented with intermittent claudication; in addition three had rest pain and three ulceration or gangrene. The length of atheromatous core removed was 10-30 cm. RESULTS: all patients had a follow-up of at least one year (range 12-27 months). Eleven arteries developed 14 stenoses. Nine became apparent within nine months of RSFE. The cumulative risk of stenoses developing in patent arteries was 24% at 6 and 63% at 12 months. Eleven angioplasties (PTA) of these stenoses were undertaken. Nine of these remain patent at a median of 12 months after PTA. At one year primary patency was 10 of 25 (40%), primary-assisted patency 18 of 25 (72%) and secondary patency 19 of 25 (76%) and at two years 29%, 57% and 57% respectively. CONCLUSIONS: RSFE is worth considering for superficial femoral artery occlusive disease, particularly in high-risk patients without suitable vein and with limited life expectancy. Careful duplex surveillance is important. Until stenoses can be prevented, the widespread use of RSFE cannot be recommended.

https://doi.org/10.1053/ejvs.1999.1021

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March 2000
5 Reads

Remote superficial femoral artery endarterectomy: medium-term results.

Eur J Vasc Endovasc Surg 2000 Mar;19(3):278-82

Department of Surgery, Royal Berkshire Hospital, Reading, UK.

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http://dx.doi.org/10.1053/ejvs.1999.1021DOI Listing
March 2000
5 Reads
2.490 Impact Factor

Retraction

The Annals of Thoracic Surgery

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March 2000
5 Reads

Acute upper limb ischemia: a complication of coronary artery bypass grafting.

Fox AD, Whiteley MS, Phillips-Hughes J, Roake J, The Annals of thoracic surgery, 1999, vol. 67, no. 2, pp. 535-6; discussion 536-7

http://europepmc.org/abstract/med/10197686

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March 2000
6 Reads

Acute upper limb ischemia: a complication of coronary artery bypass grafting.

Ann Thorac Surg 2000 Feb;69(2):664

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http://dx.doi.org/10.1016/s0003-4975(00)01076-6DOI Listing
February 2000
1 Read
1 Citation
3.850 Impact Factor

The effect of autoclave resterilisation on polyester vascular grafts.

Riepe G, Whiteley MS, Wente A, Rogge A, Schröder A, Galland RB, Imig H, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 1999, vol. 18, no. 5, pp. 386-390, 1999

http://europepmc.org/abstract/med/10610826

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December 1999
6 Reads

The effect of autoclave resterilisation on polyester vascular grafts.

Eur J Vasc Endovasc Surg 1999 Nov;18(5):386-90

Department of General, Vascular and Thoracic Surgery, General Hospital of Hamburg-Harburg, Germany.

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http://dx.doi.org/10.1053/ejvs.1999.0891DOI Listing
November 1999
6 Reads
1 Citation
2.490 Impact Factor

Physiological comparison of open and endovascular aneurysm repair.

Treharne GD, Thompson MM, Whiteley MS, Bell PR, The British journal of surgery, 1999, vol. 86, no. 6, pp. 760-764

http://europepmc.org/abstract/med/10383575

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July 1999
7 Reads

Surgical patients with methicillin resistant staphylococcus aureus infection: an analysis of outcome using P-POSSUM.

J R Coll Surg Edinb 1999 Jun;44(3):161-3

Department of Surgery, Royal Berkshire Hospital, Reading, U.K.

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June 1999
4 Citations

Calman, venous surgery and the vascular trainee.

J R Coll Surg Edinb 1999 Jun;44(3):172-6

Department of Vascular and Endovascular Surgery, St James's University Teaching Hospital, Leeds, U.K.

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June 1999
2 Reads

Physiological comparison of open and endovascular aneurysm repair.

Br J Surg 1999 Jun;86(6):760-4

Department of Vascular Surgery, Leicester Royal Infirmary, UK.

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http://dx.doi.org/10.1046/j.1365-2168.1999.01091.xDOI Listing
June 1999
3 Reads
5 Citations
5.542 Impact Factor

Assessing arterial inflow before infra-inguinal bypass grafting: a survey of the members of the Vascular Surgical Society of Great Britain and Ireland.

Cardiovasc Surg 1999 Jan;7(1):70-3

Department of Surgery, Royal Berkshire Hospital, Reading, UK.

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http://dx.doi.org/10.1016/s0967-2109(98)00048-9DOI Listing
January 1999

POSSUM and Portsmouth POSSUM for predicting mortality. Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity.

Prytherch DR, Whiteley MS, Higgins B, Weaver PC, Prout WG, Powell SJ, The British journal of surgery, 1998, vol. 85, no. 9, pp. 1217-1220

http://europepmc.org/abstract/med/9752863

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October 1998
4 Reads

Minimally invasive superficial femoral artery endarterectomy: early experience with a modified technique.

Whiteley MS, Magee TR, Torrie EP, Galland RB, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 1998, vol. 16, no. 3, pp. 254-258

http://europepmc.org/abstract/med/9787308

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October 1998
5 Reads

Minimally invasive superficial femoral artery endarterectomy: early experience with a modified technique.

Eur J Vasc Endovasc Surg 1998 Sep;16(3):254-8

Department of Surgery, Royal Berkshire Hospital, Reading, U.K.

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http://dx.doi.org/10.1016/s1078-5884(98)80228-1DOI Listing
September 1998
4 Reads
2.490 Impact Factor

POSSUM and Portsmouth POSSUM for predicting mortality. Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity.

Br J Surg 1998 Sep;85(9):1217-20

Department of Medical Physics, Portsmouth Hospitals NHS Trust, UK.

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http://dx.doi.org/10.1046/j.1365-2168.1998.00840.xDOI Listing
September 1998
9 Reads
77 Citations
5.542 Impact Factor

The fate of patients undergoing surveillance of small abdominal aortic aneurysms.

Galland RB, Whiteley MS, Magee TR, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 1998, vol. 16, no. 2, pp. 104-109

http://europepmc.org/abstract/med/9728428

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August 1998
5 Reads

The fate of patients undergoing surveillance of small abdominal aortic aneurysms.

Eur J Vasc Endovasc Surg 1998 Aug;16(2):104-9

Department of Surgery, Royal Berkshire Hospital, Reading, U.K.

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http://dx.doi.org/10.1016/s1078-5884(98)80150-0DOI Listing
August 1998
2 Citations
2.490 Impact Factor

The reduction in hours of work for surgical trainees--an enlightened move or a great mistake?

Andrews S, O'Riordan DC, Whiteley MS, Annals of the Royal College of Surgeons of England, 1998, vol. 80, no. 4 Suppl, pp. 177-180

http://europepmc.org/abstract/med/9849325

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July 1998
7 Reads

Scoring systems.

Authors:
Whiteley MS

Whiteley MS, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 1998, vol. 16, no. 1, pp. 87

http://europepmc.org/abstract/med/9715725

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July 1998
7 Reads

Doppler forceps: an instrument to identify vessels during surgical dissection.

Authors:
Whiteley MS

Whiteley MS, Annals of the Royal College of Surgeons of England, 1998, vol. 80, no. 4, pp. 269-270

http://europepmc.org/abstract/med/9771228

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July 1998
5 Reads

The role of the nurse in the pre-admission clinic.

Authors:
M Whiteley

Ann R Coll Surg Engl 1998 Jul;80(4 Suppl):192

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July 1998
17 Reads
1.223 Impact Factor

The reduction in hours of work for surgical trainees--an enlightened move or a great mistake?

Ann R Coll Surg Engl 1998 Jul;80(4 Suppl):177-80

Princess Alexandra Hospital, Harlow.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2502743PMC
July 1998
5 Reads
1.223 Impact Factor

Scoring systems.

Authors:
M S Whiteley

Eur J Vasc Endovasc Surg 1998 Jul;16(1):87

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http://dx.doi.org/10.1016/s1078-5884(98)80100-7DOI Listing
July 1998
8 Reads
2.490 Impact Factor

Doppler forceps: an instrument to identify vessels during surgical dissection.

Authors:
M S Whiteley

Ann R Coll Surg Engl 1998 Jul;80(4):269-70

Department of Surgery, Royal Berkshire Hospital, Reading.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503079PMC
July 1998
5 Reads
1.223 Impact Factor

Subfascial endoscopic perforator vein surgery (SEPS): current practice among British surgeons.

Whiteley MS, Smith JJ, Galland RB, Annals of the Royal College of Surgeons of England, 1998, vol. 80, no. 2, pp. 104-107

http://europepmc.org/abstract/med/9623373

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March 1998
5 Reads

Photoplethysmography can replace hand-held Doppler in the measurement of ankle/brachial indices.

Whiteley MS, Fox AD, Horrocks M, Annals of the Royal College of Surgeons of England, 1998, vol. 80, no. 2, pp. 96-98

http://europepmc.org/abstract/med/9623371

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March 1998
6 Reads

Full-dose and half-dose Klean Prep produce clearer images with iliac duplex examination than picolax.

Whiteley MS, Fox AD, Harris RA, Horrocks M, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 1998, vol. 15, no. 3, pp. 261-266

http://europepmc.org/abstract/med/9587343

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March 1998
4 Reads

Subfascial endoscopic perforator vein surgery (SEPS): current practice among British surgeons.

Ann R Coll Surg Engl 1998 Mar;80(2):104-7

Department of Surgery, Royal Berkshire Hospital, Reading.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2502990PMC
March 1998
2 Reads
1.223 Impact Factor

Full-dose and half-dose Klean Prep produce clearer images with iliac duplex examination than picolax.

Eur J Vasc Endovasc Surg 1998 Mar;15(3):261-6

Department of Surgery, Royal United Hospital, Combe Park, Bath, U.K.

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http://dx.doi.org/10.1016/s1078-5884(98)80188-3DOI Listing
March 1998
2 Reads
2.490 Impact Factor

Photoplethysmography can replace hand-held Doppler in the measurement of ankle/brachial indices.

Ann R Coll Surg Engl 1998 Mar;80(2):96-8

Department of Surgery, Royal United Hospital, Bath.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2502998PMC
March 1998
6 Reads
3 Citations
1.223 Impact Factor

Combined fascia and mesh closure of large incisional hernias.

J R Coll Surg Edinb 1998 Feb;43(1):29-30

Department of Surgery, Royal Berkshire Hospital, Reading, UK.

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February 1998
5 Reads
2 Citations

A specialist nurse can replace pre-registration house officers in the surgical pre-admission clinic.

Ann R Coll Surg Engl 1997 Nov;79(6 Suppl):257-60

Department of Surgery, Royal Berkshire Hospital, Reading.

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November 1997
2 Reads
1 Citation
1.223 Impact Factor

Career aspirations and expectations of vascular trainees in 1996. The Rouleaux Club.

Ann R Coll Surg Engl 1997 Sep;79(5 Suppl):195-9

Nuffield Department of Surgery, John Radcliffe Hospital, Oxford.

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September 1997
1.223 Impact Factor

Tibial nerve damage during subfascial endoscopic perforator vein surgery.

Whiteley MS, Smith JJ, Galland RB, The British journal of surgery, 1997, vol. 84, no. 4, pp. 512

http://europepmc.org/abstract/med/9112904

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May 1997
4 Reads

Tibial nerve damage during subfascial endoscopic perforator vein surgery.

Br J Surg 1997 Apr;84(4):512

Department of Surgery, Royal Berkshire Hospital, Reading, UK.

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April 1997
1 Read
1 Citation
5.542 Impact Factor

Attitudes of patients to elective surgical admissions over Christmas and Easter.

Ann R Coll Surg Engl 1997 Mar;79(2 Suppl):68-71

Department of Surgery, Princess Margaret Hospital, Swindon.

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March 1997
3 Reads
1.223 Impact Factor

Regarding "presidential address: vascular surgery--comparing outcomes".

Whiteley M, Prytherch D, Journal of vascular surgery, 1996, vol. 24, no. 6, pp. 1066

http://europepmc.org/abstract/med/8976362

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1996
9 Reads

Abnormal suntanning following transthoracic endoscopic sympathectomy.

Whiteley MS, Ray-Chaudhuri SB, Galland RB, The British journal of surgery, 1996, vol. 83, no. 12, pp. 1782

http://europepmc.org/abstract/med/9038569

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1996
6 Reads

Regarding "presidential address: vascular surgery--comparing outcomes".

J Vasc Surg 1996 Dec;24(6):1066

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http://dx.doi.org/10.1016/s0741-5214(96)70055-1DOI Listing
December 1996
1 Read
3.021 Impact Factor

Abnormal suntanning following transthoracic endoscopic sympathectomy.

Br J Surg 1996 Dec;83(12):1782

Department of Surgery, Royal Berkshire Hospital, Reading, UK.

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http://dx.doi.org/10.1002/bjs.1800831238DOI Listing
December 1996
2 Reads
5.542 Impact Factor

Tumor necrosis factor receptor: Fc fusion protein in septic shock.

Authors:
Whiteley MS

Whiteley MS, The New England journal of medicine, 1996, vol. 335, no. 21, pp. 1607-8; author reply 1608-9

http://europepmc.org/abstract/med/8927111

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December 1996
6 Reads

Tumor necrosis factor receptor: Fc fusion protein in septic shock.

Authors:
M S Whiteley

N Engl J Med 1996 Nov;335(21):1607-8; author reply 1608-9

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November 1996
1 Read
55.873 Impact Factor

General surgery with a special interest in vascular surgery: changing patterns of workload.

Whiteley MS, Ray-Chaudhuri SB, Cornes J, Michaels JA, Galland RB, The British journal of surgery, 1996, vol. 83, no. 10, pp. 1364-1366

http://europepmc.org/abstract/med/8944452

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October 1996
7 Reads

Changing patterns in aortoiliac reconstruction: a 7-year audit.

Whiteley MS, Ray-Chaudhuri SB, Galland RB, The British journal of surgery, 1996, vol. 83, no. 10, pp. 1367-1369

http://europepmc.org/abstract/med/8944453

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October 1996
6 Reads

Changing patterns in aortoiliac reconstruction: a 7-year audit.

Br J Surg 1996 Oct;83(10):1367-9

Department of Surgery, Royal Berkshire Hospital, Reading, UK.

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http://dx.doi.org/10.1002/bjs.1800831012DOI Listing
October 1996
2 Citations
5.542 Impact Factor

General surgery with a special interest in vascular surgery: changing patterns of workload.

Br J Surg 1996 Oct;83(10):1364-6

Department of Surgery, Royal Berkshire Hospital, Reading, UK.

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http://dx.doi.org/10.1002/bjs.1800831011DOI Listing
October 1996
3 Reads
2 Citations
5.542 Impact Factor

Diagnosis of arterial disease of the lower extremities with duplex ultrasonography.

Authors:
Whiteley M

Whiteley M, The British journal of surgery, 1996, vol. 83, no. 6, pp. 867

http://europepmc.org/abstract/med/8696761

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July 1996
3 Reads

An evaluation of the POSSUM surgical scoring system.

Whiteley MS, Prytherch DR, Higgins B, Weaver PC, Prout WG, The British journal of surgery, 1996, vol. 83, no. 6, pp. 812-815

http://europepmc.org/abstract/med/8696749

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July 1996
6 Reads

An evaluation of the POSSUM surgical scoring system.

Br J Surg 1996 Jun;83(6):812-5

Department of Surgery, Queen Alexandra Hospital, Portsmouth, UK.

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http://dx.doi.org/10.1002/bjs.1800830628DOI Listing
June 1996
3 Reads
35 Citations
5.542 Impact Factor

Diagnosis of arterial disease of the lower extremities with duplex ultrasonography.

Authors:
M Whiteley

Br J Surg 1996 Jun;83(6):867

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http://dx.doi.org/10.1002/bjs.1800830642DOI Listing
June 1996
1 Read
5.542 Impact Factor

Use of hand-held Doppler to identify 'difficult' forearm veins for cannulation.

Whiteley MS, Chang BY, Marsh HP, Williams AR, Manton HC, Horrocks M, Annals of the Royal College of Surgeons of England, 1995, vol. 77, no. 3, pp. 224-226

http://europepmc.org/abstract/med/7598423

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January 1996
7 Reads

Use of hand-held Doppler to identify 'difficult' forearm veins for cannulation.

Authors:
M Whiteley

Ann R Coll Surg Engl 1996 Jan;78(1):73

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2502673PMC
January 1996
3 Reads
1.223 Impact Factor

Iso-osmotic bowel preparation improves the accuracy of iliac artery colour flow duplex examination.

Whiteley MS, Fox AD, Harris RA, Horrocks M, Journal of the Royal Society of Medicine, 1995, vol. 88, no. 11, pp. 657P-660P

http://europepmc.org/abstract/med/8544154

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December 1995
6 Reads

Iso-osmotic bowel preparation improves the accuracy of iliac artery colour flow duplex examination.

J R Soc Med 1995 Nov;88(11):657P-660P

Department of Surgery, Royal United Hospital, Bath, England, UK.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1295393PMC
November 1995
3 Reads
2.020 Impact Factor

Do-it-yourself femoropopliteal bypass.

Fox AD, Rai A, Budd JS, Whiteley MS, Chalmers AH, Annals of the Royal College of Surgeons of England, 1995, vol. 77, no. 5, pp. 392-394

http://europepmc.org/abstract/med/7486771

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October 1995
4 Reads

Do-it-yourself femoropopliteal bypass.

Ann R Coll Surg Engl 1995 Sep;77(5):392-4

University Department of Surgery, Royal United Hospital, Bath

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2502411PMC
September 1995
1.220 Impact Factor

Aortoiliac segment examination with colour flow Duplex--a pilot study using Klean Prep. to improve the image quality.

Whiteley MS, Harris RA, Horrocks M, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 1995, vol. 10, no. 2, pp. 192-197

http://europepmc.org/abstract/med/7655971

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August 1995
5 Reads

Aortoiliac segment examination with colour flow Duplex--a pilot study using Klean Prep. to improve the image quality.

Eur J Vasc Endovasc Surg 1995 Aug;10(2):192-7

Department of Surgery, Royal United Hospital, Bath, U.K.

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http://dx.doi.org/10.1016/s1078-5884(05)80111-xDOI Listing
August 1995
2 Reads
1 Citation
2.490 Impact Factor

Use of hand-held Doppler to identify 'difficult' forearm veins for cannulation.

Ann R Coll Surg Engl 1995 May;77(3):224-6

Department of Surgery, Royal United Hospital, Bath.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2502093PMC
May 1995
2 Citations
1.220 Impact Factor

The Glastonbury Festival 1993: pattern of attendances and admissions to an NHS Trust.

Britten S, Whiteley MS, Fox PF, Goodwin MI, Horrocks MJ, Journal of accident & emergency medicine, 1995, vol. 12, no. 1, pp. 30-31

http://europepmc.org/abstract/med/7640825

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March 1995
5 Reads

Comparative audit of colorectal resection with the POSSUM scoring system.

Whiteley MS, Prytherch D, Higgins B, Weaver PC, Prout WG, The British journal of surgery, 1995, vol. 82, no. 3, pp. 425-426

http://europepmc.org/abstract/med/7796042

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March 1995
8 Reads

The Glastonbury Festival 1993: pattern of attendances and admissions to an NHS Trust.

J Accid Emerg Med 1995 Mar;12(1):30-1

Department of Orthopaedic Surgery, Royal United Hospital, Combe Park, Bath, UK.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1342514PMC
http://dx.doi.org/10.1136/emj.12.1.30DOI Listing
March 1995
2 Reads
1 Citation

Comparative audit of colorectal resection with the POSSUM scoring system.

Br J Surg 1995 Mar;82(3):425-6

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http://dx.doi.org/10.1002/bjs.1800820358DOI Listing
March 1995
3 Reads
2 Citations
5.540 Impact Factor

Bowel preparation.

Whiteley MS, Fox AD, Horrocks M, Clinical radiology, 1994, vol. 49, no. 11, pp. 841

http://europepmc.org/abstract/med/7955859

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December 1994
6 Reads

Bowel preparation.

Clin Radiol 1994 Nov;49(11):841

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http://dx.doi.org/10.1016/s0009-9260(05)81982-8DOI Listing
November 1994
6 Reads
1.660 Impact Factor

Use of a hand-held Doppler to avoid abdominal wall vessels in laparoscopic surgery.

Whiteley MS, Laws SA, Wise MH, Annals of the Royal College of Surgeons of England, 1994, vol. 76, no. 5, pp. 348-350

http://europepmc.org/abstract/med/7661918

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October 1994
7 Reads

Use of a hand-held Doppler to avoid abdominal wall vessels in laparoscopic surgery.

Ann R Coll Surg Engl 1994 Sep;76(5):348-50

Department of Surgery, St Mary's Hospital, Portsmouth.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2502398PMC
September 1994
4 Reads
2 Citations
1.220 Impact Factor

Ruptured renal artery aneurysm in the first trimester of pregnancy.

Whiteley MS, Katoch R, Kennedy RH, Bidgood KA, Baird RN, European journal of vascular surgery, 1994, vol. 8, no. 2, pp. 238-239

http://europepmc.org/abstract/med/8181624

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March 1994
7 Reads

Ruptured renal artery aneurysm in the first trimester of pregnancy.

Eur J Vasc Surg 1994 Mar;8(2):238-9

Department of Surgery, Royal Infirmary, Bristol, U.K.

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http://dx.doi.org/10.1016/s0950-821x(05)80469-4DOI Listing
March 1994
3 Reads
1 Citation

Raised serum CA125 level in leiomyoma and leiomyosarcoma of gastrointestinal origin.

Whiteley MS, Marshall J, The British journal of surgery, 1993, vol. 80, no. 12, pp. 1551

http://europepmc.org/abstract/med/8298923

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1993
4 Reads

Raised serum CA125 level in leiomyoma and leiomyosarcoma of gastrointestinal origin.

Br J Surg 1993 Dec;80(12):1551

Department of Surgery, St Mary's Hospital, Portsmouth, UK.

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http://dx.doi.org/10.1002/bjs.1800801220DOI Listing
December 1993
3 Citations
5.542 Impact Factor

Randomized study of the value of laparoscopy before appendicectomy.

Authors:
Whiteley MS

Whiteley MS, The British journal of surgery, 1993, vol. 80, no. 11, pp. 1490

http://europepmc.org/abstract/med/8110257

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December 1993
6 Reads

Herniation at the site of cannula insertion after laparoscopic cholecystectomy.

Authors:
Whiteley MS

Whiteley MS, The British journal of surgery, 1993, vol. 80, no. 11, pp. 1488

http://europepmc.org/abstract/med/8252367

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December 1993
6 Reads

Colour Duplex imaging through wound dressings.

Whiteley MS, Magee TR, Harris R, Horrocks M, European journal of vascular surgery, 1993, vol. 7, no. 6, pp. 713-716

http://europepmc.org/abstract/med/8270077

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December 1993
7 Reads

Randomized study of the value of laparoscopy before appendicectomy.

Authors:
M S Whiteley

Br J Surg 1993 Nov;80(11):1490

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http://dx.doi.org/10.1002/bjs.1800801141DOI Listing
November 1993
1 Read
5.540 Impact Factor

Herniation at the site of cannula insertion after laparoscopic cholecystectomy.

Authors:
M S Whiteley

Br J Surg 1993 Nov;80(11):1488

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November 1993
1 Read
5.540 Impact Factor

Colour Duplex imaging through wound dressings.

Eur J Vasc Surg 1993 Nov;7(6):713-6

Department of Surgery, Royal United Hospital, Bath, Avon, U.K.

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http://dx.doi.org/10.1016/s0950-821x(05)80722-4DOI Listing
November 1993
4 Reads

Medical treatment at Glastonbury Festival.

Britten S, Whiteley MS, Fox PF, Goodwin MI, Horrocks M, BMJ (Clinical research ed.), 1993, vol. 307, no. 6910, pp. 1009-1010

http://europepmc.org/abstract/med/8241897

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October 1993
5 Reads

Annual influx of temporary residents. To the Glastonbury Festival...

Britten S, Whiteley MS, Fox PF, Goodwin MI, Horrocks M, BMJ (Clinical research ed.), 1993, vol. 307, no. 6903, pp. 561

http://europepmc.org/abstract/med/8400986

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August 1993
5 Reads

Involvement of the axillary artery within fracture callus.

Whiteley MS, Dixon JH, Injury, 1992, vol. 23, no. 1, pp. 62-63

http://europepmc.org/abstract/med/1541508

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1992
6 Reads

An unusual complication of laparoscopic cholecystectomy.

Authors:
Whiteley M

Whiteley M, Annals of the Royal College of Surgeons of England, 1992, vol. 74, no. 6, pp. 441

http://europepmc.org/abstract/med/1471852

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December 1992
6 Reads

An unusual complication of laparoscopic cholecystectomy.

Authors:
M Whiteley

Ann R Coll Surg Engl 1992 Nov;74(6):441

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2497705PMC
November 1992
1 Read
1 Citation
1.220 Impact Factor

Involvement of the axillary artery within fracture callus.

Injury 1992 ;23(1):62-3

Department of Orthopaedic Surgery, Weston General Hospital, Weston-super-Mare, Avon, UK.

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http://dx.doi.org/10.1016/0020-1383(92)90133-dDOI Listing
April 1992
4 Reads
2.140 Impact Factor

Bystander resuscitation: is the public enthusiastic?

Skinner DV, Whiteley M, Miles S, Camm AJ, Archives of emergency medicine, 1986, vol. 3, no. 4, pp. 259-260

http://europepmc.org/abstract/med/3801115

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1986
9 Reads

Top co-authors

Judith M Holdstock
Judith M Holdstock

1 The Whiteley Clinic

6
Judy M Holdstock
Judy M Holdstock

The Whiteley Clinic

5
Charmaine C Harrison
Charmaine C Harrison

The Whiteley Clinic

5
Alexandra E Ostler
Alexandra E Ostler

The Whiteley Clinic

4
C Smith
C Smith

University College London

4
Emma B Dabbs
Emma B Dabbs

1 The Whiteley Clinic

4
Petra Marsh
Petra Marsh

The Whiteley Clinic

2
B Higgins
B Higgins

Queen Alexandra Hospital

2