LEG ULCER CRISIS: Is Foam Sclerotherapy the ONLY Solution? | Haroun Gajraj & Gareth Bate | Podcast

## 🇬🇧 The English Method of Foam Sclerotherapy: In-Depth with Gareth Bate Join **Haroun Gajraj** as he catches up with **Clinical Nurse Specialist Gareth Bate**, one of the founding members of the British Association of Sclerotherapists (BAS) and a leading international expert in varicose vein treatment. In this insightful episode, Gareth Bate delivers a comprehensive presentation on the **English Method of Ultrasound-Guided Foam Sclerotherapy**, sharing its history in the UK and detailing the refined technique developed over two decades. --- ### **🎙️ What You'll Learn in This Episode:** * **The History of Foam Sclerotherapy in the UK:** Gareth Bate discusses the early days, starting with the Varisolve trial and the crucial roles of Andrew Bradbury and Philip Coleridge-Smith in pioneering the technique in England. * **The "English Method" Explained:** Discover the key features that distinguish this approach, including the use of **multiple cannulae** (often one every 20cm) to ensure fresh foam contact in all vein segments, varying concentrations of Sodium Tetradecyl Sulphate (STS) for different vein sizes, and the practice of **leg elevation** during treatment. * * **Why Stripping Surgery Persists in 2025:** A surprising and concerning discussion on the continued use of surgical stripping for varicose veins in the NHS, despite the overwhelming evidence and availability of less-invasive methods. * **Addressing Concerns about Deep Vein Bubbles:** Gareth offers expert reassurance on the phenomenon of seeing foam bubbles in deep veins, explaining why it's typically harmless and what measures they take to mitigate any risk. * **The Varicose Vein Treatment Landscape:** Insights into the changing practice in the NHS post-COVID and the growth of the private sector for this affordable treatment. * **The Leg Ulcer Crisis:** A powerful and candid discussion on the "shockingly bad" state of leg ulcer care in the UK, stressing the essential role of compression and timely intervention (like Foam Sclerotherapy) for the most vulnerable patients. * **Foam Sclerotherapy: Art vs. Science:** Gareth describes the technique as an "art" that requires great attention to detail and skill, arguing it is the most complex, yet most rewarding, method for achieving excellent patient-reported outcomes. --- ### **🔍 Episode Highlights & Key Timestamps:** 00:03 Introduction to Gareth Bate and the surprising continued use of stripping surgery in the UK. 02:47 The dramatic drop in NHS-funded vein treatments following changes to commissioning criteria. 04:58 Why Foam Sclerotherapy, despite appearing simple, is perhaps the most complex way to treat varicose veins. 06:11 Gareth Bate's presentation: From working in operating theatres to learning ultrasound and pioneering foam treatment. 08:03 The Varisolve trial—the start of Foam Sclerotherapy in Birmingham. 11:15 Detailing the **Modern English Method**: Multiple cannulae, position, and not compressing the junctions. 14:00 The importance of a specific compression bandaging and walking regime. 18:11 Post-presentation chat: The key difference of the English Method in just two sentences. 23:05 Addressing the fear of bubbles in the deep veins. 31:33 Why patient satisfaction (PROMs) is the most critical endpoint, not just duplex recurrence rates. 34:00 The UK's crisis in venous leg ulcer treatment. 41:25 Arguing for Foam Sclerotherapy as the ideal first choice for many ulcer patients. 46:00 Preview of Gareth Bate's live demonstration at the upcoming BAS Conference. --- ### **👉 Connect with Haroun Gajraj and Gareth Bate** Gareth Bate on Linkedin https://www.linkedin.com/in/gareth-bate-8469a04b/ Haroun Gajraj on Linkedin https://www.linkedin.com/in/dr-haroun-gajraj/ BECOME A MEMBER OF THE BRITISH ASSOCIATION OF SCLEROTHERAPISTS https://www.thebas.uk/membership If you're interested in the latest techniques, research, and best practices in Phlebology, don't miss this in-depth discussion from two of the most experienced voices in the field. **#FoamSclerotherapy #VaricoseVeins #EnglishMethod #BAS #LegUlcers #VascularSurgery #GarethBate #HarounGajraj**