T.J. Fernandez-Hart's research while affiliated with Central London Physiotherapy and Sports Injury Clinics and other places

Publications (9)

Chapter
The instructions for use of endovenous laser ablation for the treatment of varicose veins usually includes commencement of treatment 2 cm back from the saphenofemoral junction. However, this can lead to a "stump" that can result in a clot called an endovenous heat induced thrombosis (EHIT). The bubble trapped technique is a technique developed by t...
Article
Objectives Pelvic vein embolisation is increasing in venous practice for the treatment of conditions associated with pelvic venous reflux. In July 2014, we introduced a local anaesthetic “walk-in walk-out” pelvic vein embolisation service situated in a vein clinic, remote from a hospital. Methods Prospective audit of all patients undergoing pelvic...
Article
Objectives Endovenous thermal ablation (EVTA) of varicose veins was introduced in the late 1990s with radiofrequency ablation (RFA) using the VNUS Closure device. The results of the original VNUS Closure device for the abolition of truncal venous reflux at 15 years are reported. Methods A prospective audit of a group of patients treated with VNUS...
Article
Objective/Background 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 st...
Article
Objective 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). Methods Between March 2012 and July 2013, 756 patients (122 men, 634 women) with primary varicose veins (mean age, 53 years; range, 18-89...

Citations

... For the forward firing laser, the tip was placed near this point and external pressure was applied via the ultrasound probe, compressing the vein and attempting to trap the thermal energy as represented by the steam bubbles visualised on ultrasound (the 'Bubble Trap Technique'). 11 Subsequently, ablation was performed with both devices using a power of 10 W, and pullback of 6 to 9 cm/s giving a linear endovenous energy density (LEED) of 60 to 90 J/s. Pullback speed and, as the power was kept at 10 W, hence LEED were selected on vein diameter and vein wall thickness. ...
... Стремление к минимизации операционной травмы и повышению эстетичности лечения СТВП при-вели к разработке и широкому применению методики ЭГВ спиралями [7,[21][22][23][24][25]. В подавляющем большинстве авторы этих исследований указывают на 100% редукцию кровотока по ГВ и высокий эстетический эффект. ...
... The technique was extremely easy to apply, very reliable both in terms of patient's satisfaction and the clinical results. On the other hand, Whiteley et al., 2017 [21] ; reported neovascularization, the most common cause of recurrence, in three patients (2%) in his study on fifty-eight patients (91 legs), the origin couldn't be confirmed, but all three patients under went previous traditional surgical procedures before presenting to their study for RFA. Therefore, it is highly unlikely it was theconsequence of RFA, especially considering the low neovascular occurrence within the remaining cohort and the previously published data of the lack of neovascularization after RFA in primary varicose veins as shown by Kianifard et al., 2006 [22] . ...
... They revolutionized the treatment by shifting away from hospital-based stripping procedures to office based endovenous procedures. In addition to the obvious benefits of reduced pain and faster recovery times with thermal procedures, the durability of both laser and radiofrequency methods have been proven in long-term follow up studies [1][2][3] . ...
... The second-line treatment for incompetent N2 truncal veins is ultrasound guided foam sclerotherapy (UGFS). [43][44][45] Although some doctors advocate this as the optimal treatment for truncal vein incompetence due to simplicity in terms of equipment and administration, and reduced cost compared to EVTA devices, 94 both laboratory-based models of sclerotherapy in veins with thick walls 95 and clinical studies have shown an inferior long-term occlusion of incompetent truncal veins compared to EVTA. 96 UGFS is more successful if given by catheter rather than injected up the vein from a single point, 97 and with tumescence injected around the vein, increasing the sclerosant dwell time. ...
... Primary avalvular varicose anomaly (PAVA) is a new phenomenon defined as tortuous, thin-walled and incompetent veins in patients presenting with primary varicose veins (VVs), resembling neovascularized tissue on ultrasound and surgical examination [1]. ...