In 2000, Mr Braithwaite was awarded a travelling scholarship, by the American College of Surgeons, to study deep venous surgery at the Straub Clinic in Honolulu, USA. There he worked with two of the world’s experts in deep venous surgery, Dr Robert Kistner and Dr Bo Eklof.
Since his return, Mr Braithwaite has set up facilities for the investigation of deep venous Surgery. Surgeons in Nottingham use a technique that creates a new valve in the common femoral vein. Up until December 2009, 5 patients have had deep venous surgery for symptoms that were not controlled by simple measures like stockings.
Some 4 patients have had both a subjective and objective improvement in their legs. They have had less pain and increased mobility. In one patient the valve did not work and they developed a DVT.
Mr Braithwaite is happy to receive referrals to consider patients for deep venous surgery.
The research programme has been approved by the Governance committee of the Queens Medical Centre in Nottingham. In addition, the UK government agency NICE has considered deep venous surgery as an approved technique under investigation.
What happens if you are referred for consideration of deep venous surgery?
If you and your GP or hospital specialist would like an opinion then Mr Braithwaite would see you in his one stop vascular clinic. During the clinic you will be interviewed and examined by Mr Braithwaite. If required, he will arrange a venous duplex ultrasound of your leg veins. You may then need another test called strain gauge plethysmography.
Strain gauge plethysmography is a test that measures how the blood in the veins moves when you are in different positions.
What happens with the results of the one-stop clinic tests?
You will be advised whether it might be possible to treat any deep vein damage surgically. If you are prepared to have an operation then a final test called a venogram will be arranged. This allows Mr Braithwaite to decide what, if anything can be done.
Will I be suitable for deep vein Surgery?
This depends on your symptoms and the results of your tests.
Does deep venous surgery work?
We do not know. That is why there is a research programme. Many surgeons do not think there is any evidence that deep vein surgery works. There have been articles written to support this viewpoint.
Mr Braithwaite was not sure whether deep veins surgery works. He has been surprised by the good initial results he has achieved but needs to know more.
If you want to be considered for deep vein surgery, you need to understand that doctors have little knowledge on how well the surgery works.