New Direction

State-of-the-art, in-office treatment heals venous ulcers.

For nearly 35 years, Jamaica native Winsome Wilson has worked as a certified nursing assistant. Her profession requires quite a bit of standing and walking to care for her patients. All that time on her feet had an adverse effect on Winsome’s legs that led to many distressing symptoms.

Dr. Thomas Ashton of Ashton Vein Center in Palm Beach Gardens treated Winsome Wilson’s painful and unsightly legs affected by venous insufficiency with transcatheter scleroablation (chemical closure).

A unique chemical closure procedure has revitalized Winsome’s legs.

“I was experiencing a lot of burning, numbness and itching in both legs,” Winsome shares. “There was also redness, discoloration and terrible swelling. Sometimes, there’d be throbbing pain in my legs as well. I couldn’t wait to get home after work to elevate my legs, which helped a little, but wasn’t sufficient for relief.

“I didn’t see any bulging varicose veins, but there were dark, ugly, crusty-looking spots, especially in one area. There were burst veins and ulcers, which looked awful. My legs were in really bad shape, but I was told there was no treatment for my legs and that no doctor could help me with them.”

In desperation, Winsome visited a vein center, where the staff performed a sonogram examination of her legs. There was much, however, that the examination did not reveal, including the cause of her leg problems. Winsome left there disheartened and confused.

Determined to find the cause of the problem, Winsome decided to seek help elsewhere. She went online and discovered Ashton Vein Center in Palm Beach Gardens. Ashton Vein Center is the practice of Thomas Ashton, MD, a general surgeon dedicated to the modern evaluation and treatment of venous disorders.

“Winsome arrived with painful legs and active ulcers at her ankles,” Dr. Ashton observes. “Her condition was caused by the reflux of blood in her leg veins. Blood was flowing down her legs when it’s supposed to flow upward, toward her heart. This reverse flow was the result of damage to the valves inside her leg veins. It’s a condition called venous insufficiency.

“Venous insufficiency occurs because of heredity, pregnancy or sometimes trauma to the legs, which causes the valves to fail. When blood flows down the leg, it puts the lower leg under too much pressure, which results in leaking veins. That can lead to a breakdown of the skin and venous ulcers.”

When Winsome first went to Ashton Vein Center, she didn’t let Dr. Ashton or his staff touch her legs. The reason, she says, was that her skin in that area had become so delicate that it was prone to injury.

“I couldn’t allow anything to scratch my legs because if the skin ruptured, it would take months to resolve, to close up the wounds,” Winsome explains.

“Dr. Ashton told me he could take care of me and scheduled a treatment appointment for three weeks. Then, for some reason, my legs got worse and started causing me a lot more problems and a lot more pain. I actually had to take off of work because of it.

“My daughter called Ashton Vein Center and asked if I could come in before the three weeks, and they said, Come in today. They took one look at my legs and decided to perform the first procedure on my left leg, which was worse than my right.

“I was in the room in tears and not because the procedure was painful. They were tears of joy and relief knowing that somebody cared and was helping me.”

Anatomy Matters

Studies show that nearly 60 percent of the US population will have a venous problem in their lifetime, Dr. Ashton reports. That means that of the approximately 360 million people in this country, 210 million will suffer a venous disorder. Of those, less than ten percent seek treatment.

“Venous disease is not only the most common disease on the planet, it’s also the most under-recognized, underdiagnosed and undertreated,” Dr. Ashton asserts. “As vein specialists, we need to train physicians to recognize this condition so it can be addressed rather than ignored.

“We’ve started the Vein Center Academy, which teaches physicians not only how to recognize venous disease, but also how to set up their practices to treat it.”

When venous disease is diagnosed, there are modern, minimally invasive treatments to seal the leaking veins and reroute blood flow to nearby healthy veins. Among these techniques is endovenous laser ablation.

During endovenous laser ablation, Dr. Ashton uses a laser placed in the patient’s vein through a tiny incision in the leg to safely collapse incompetent veins. Treatment begins with a comprehensive examination, including imaging to determine which veins are leaking.

“Winsome’s evaluation included a physical examination and thorough history to determine which types of treatment she’s had in the past,” Dr. Ashton says. “To make a proper diagnosis, we performed duplex ultrasound mapping of the vein system in her legs.

“We confirmed that she had venous insufficiency, particularly in the greater saphenous veins in both legs. We knew that her ulcers weren’t going to heal unless we fixed those veins and eliminated them from circulation. The leaking veins were causing the problems in her lower legs due to hydrostatic pressure, which caused her swelling, discomfort and ulcers.”

Unfortunately, Winsome’s vein anatomy was not conducive to using laser ablation to seal her leaking veins. In her case, Dr. Ashton chose to close her veins with an alternative procedure called transcatheter scleroablation. This option involves injecting special sclerosing medication into leaking veins.

“Transcatheter scleroablation is another method of closing problem veins,” Dr. Ashton confirms. “During scleroablation, we do an infusion and fill the entire vein with the medication. The vein closes through a process called sclerotherapy. It’s essentially a chemical closure rather than using a laser or radiofrequency energy to seal leaking veins.

“With this process, we close the problem veins, which the body eventually absorbs, so they no longer cause trouble in the lower legs. We reverse the venous insufficiency, which creates a healthy environment for the skin so ulcers can heal.”

Almost Perfect

Dr. Ashton performed transcatheter scleroablation on Winsome in August 2018. By November, the ulcers on her legs were closed. She’s extremely pleased with the outcome of her procedures.

“My legs are wonderful,” Winsome marvels. “I can stand for prolonged periods and walk without pain. I can put shoes on my feet and massage my legs. I couldn’t touch my legs or do those things before the treatment. It’s amazing.”

Winsome is not only happy with how her legs feel since the treatment, she’s excited about their appearance as well. Without the venous insufficiency and resulting ulcers, the condition of her skin improved dramatically.

“My legs are almost perfect now,” she enthuses. “I have no burning, no pain, and the discoloration is going away. My legs look so good. They’re normal legs like everybody else has. My kids are happy with the results, and the doctor and his staff are happy with the results.

“I’m so relieved. Dr. Ashton and his procedure were the answer to my prayers. I’m so grateful for the doctor’s help. I recommend Dr. Ashton and Ashton Vein Center to anybody with vein problems. Ashton Vein Center is the first place people should go. I don’t think any other doctor in America could do what Dr. Ashton did for me.”

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    • Ashton Vein Center

      The Phlebologists at the Ashton Vein Center in Palm Beach, FL offer the most comprehensive vein care methods and procedures available anywhere. The entire staff is active in the American College of Phlebology and enthusiastically participates i... Read More

    • Thomas Ashton, MD, FACPh

      Thomas Ashton, MD, FACPh, is board certified by the American Board of Phlebology. He earned his medical degree from Rush University College of Medicine in Chicago, where he also completed a five-year residency in general surgery in 1984. Dr. A... Read More