Mr Ian Franklin areas of expertise:

Professional statement

Mr Ian Franklin is a London-based leading specialist in vascular and endovascular surgery. His specialist interests include varicose and thread veins, aesthetic phlebology, pelvic vein congestion, deep vein thrombosis, leg swelling, and leg ulcers. Ian Franklin was a NHS doctor for 23 years including 12 years as consultant vascular surgeon at Imperial College NHS Trust performing a full range of arterial, venous and emergency vascular surgery. He is now a full-time private venous specialist, practising in various locations across the capital. He introduced key minimally invasive treatments to the NHS and has written numerous scientific papers, book chapters and a surgical textbook. Mr Franklin is involved in the education and training of other specialists in modern vein techniques all over the world and is the programme director of the International Charing Cross Venous Course held in London every April. He is a former member of the Council of the Vascular Society of Great Britain and Ireland and served as chairman of the Circulation Foundation. He is President Elect of the Royal Society of Medicine Venous Forum.

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Varicose veins and thread veins: freque...

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What are leg ulcers?

Varicose veins and thread veins: what's...

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Credentials

GMC: ‍3461118

Professional experience

• More than 25 years of experience
• Consultant Vascular Surgeon, The Cadogan Clinic
• Consultant Vascular Surgeon, King Edward VII Hospital
• Consultant Vascular Surgeon, The Lister Hospital

...

Sub-specialties

• Varicose veins
• Thread veins
• Deep vein thrombosis
• Leg swelling
• Leg ulceration
• Lymphoedema
• Aesthetic phlebology
• Pelvic vein congestion

...

Teaching posts

• Honorary Clinical Senior Lecturer (Imperial College)

Education

• Imperial College, London

Professional membership

• Programme Director, International Charing Cross Venous Course
• Vascular Society of Great Britain and Ireland
• European Society for Vascular Surgery
• Venous Forum
• British Medical Association
• Association of Surgeons of Great Britain and Ireland

...

Languages spoken

English

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B S. Verified Patient
10/10/2017

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Patients comments

Mr franklin is a very honest man, i will definitely recommend. i’m so happy with my treatment i received.the staff are friendly!

D L. Verified Patient
21/07/2017

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E B. Verified Patient
04/07/2017

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Diseases, Medical Tests and Treatments

Deep vein thrombosis

Deep vein thrombosis occurs when a blood clot forms in a vein deep in the thigh or calf. It causes swelling, a red patch or an ache in the leg, and ca ...

Leg ulcers

A leg ulcer occurs when a lesion on the lower leg becomes infected and takes longer than usual to heal. Older people and diabetics are more prone to t ...

Lymphoedema

What is lymphoedema? Lymphoedema is a chronic condition characterised by swelling in the tissues of the body along with fluid retention, as the bod ...

Pelvic congestion syndrome

What is pelvic congestion syndrome? Pelvic congestion syndrome (PCS) is a chronic condition in women that causes a persistent dull pain in the pelv ...

Spider veins

What are spider veins? Spider veins are milder versions of varicose veins and are smaller, red and blue blood vessels that are visible on the surface of the skin. Their appearance resembles a spider’s web or tree branches. You will usually have them on your legs and face and they are more common in women than in men. Symptoms of spider veins: Spider veins are usually symptomless and don’t pose a health problem, however, sometimes you might experience itchiness. What are the causes of spider veins? Spider veins develop when the valves in your leg veins weaken, allowing blood to flow backwards. Spider veins appear blue because the blood in them is deoxygenated. There are several factors that increase your risk of developing spider veins, including: Age Pregnancy Use of oral contraceptives Family history Obesity Sex – women are more likely to have spider veins. Standing up or sitting down for long periods. Can spider veins be prevented? Spider veins are not completely preventable, but measures to improve blood circulation can reduce the chances of them developing. The following will help: Maintaining a healthy weight Exercising regularly Eating a low sodium diet with lots of fibre Take breaks when sitting or standing for long periods Avoid tight trousers and high heels Treatments for spider veins: Taking measures to improve blood circulation and healthy lifestyle measures are the main methods of improving or reducing the number of spider veins you have and treatments or surgery are usually reserved for larger varicose veins that are either not aesthetically pleasing or have painful symptoms. Which type of specialist treats spider veins? A vascular surgeon, dermatologist or aesthetic medicine specialist would treat spider veins. ...

Varicose veins

What are varicose veins? Varicose veins are enlarged and swollen veins, usually forming in the legs and feet. Often they can appear as lumpy, blue or purple and bulging. Although varicose veins are frequently a cosmetic concern, for some people they can also cause pain and discomfort, and can sometimes lead to more serious problems. There are different types of varicose veins, including: Reticular – red and grouped closely together. Trunk – close to the skin’s surface and very thick. Telangiectasia – also known as spider veins, they appear as small groups of blue or red veins that do not bulge. What are the symptoms of varicose veins? The main symptoms of varicose veins include: heavy, aching legs burning or throbbing in the legs dry, itchy skin on the affected veins cramps in the legs, especially at night swollen ankles and feet What causes varicose veins? Varicose veins occur when the valves inside the veins malfunction. Blood should flow smoothly to the heart, but if a valve is weakened or damaged, blood can flow backwards and collect in the veins. This eventually results in swollen, varicose veins. There are certain risk factors associated with developing varicose veins, including: older age pregnancy being female being overweight having family members with varicose veins standing for long periods over time How can varicose veins be prevented? There is little evidence that indicates varicose veins can be prevented, however, techniques that improve circulation are thought to reduce the risk of developing them. There are also measures that can help relieve the symptoms caused by varicose veins: Exercising regularly, to maintain a healthy weight and to improve circulation. Avoid standing for long periods, and to move around frequently. If there is pain, raise the legs on pillows throughout the day to relieve the discomfort. What is the treatment for varicose veins? Initially, treatment for varicose veins is usually the use of compression socks or stockings, exercising regularly and elevating the legs when in discomfort. However, if they are still causing pain and discomfort or have caused complications, then there are other treatment options, including: Sclerotherapy – special foam is used to close the affected veins. Endothermal ablation – heat is used to seal the veins. Ligation and stripping – the affected veins are removed. ...

Endovascular surgery

What is it? Endovascular surgery is a minimally invasive surgery performed under local anaesthetic. A range of endovascular techniques are employed to unblock, repair, or reroute blood vessels to treat various cardiovascular conditions. These techniques are less invasive than open vascular surgery and can lead to fewer complications after the operation. What is it for? This type of surgery is often done to treat an aortic aneurysm. Abdominal aortic aneurysm can arise as a consequence of unhealthy lifestyle choices, such as smoking, stress, lack of physical activity and eating an unhealthy diet. When treating an aneurysm, the main goal is to avoid the rupturing of the aneurysmal sac; that is accomplished with the use of a specific stent. On the other hand, when treating a stroke, endovascular surgery aims at eliminating the obstructions from within the arteries. This branch of surgery also treats conditions such as stroke, stenosis, peripheral arterial disease and other issues associated with the vascular system. What does it involve? Endovascular surgery involves making a small incision in the skin and passing a small tube called a catheter into a blood vessel at the target site. Whenever endovascular surgery is done to treat an aneurysm of the visceral arteries, a small cut is made at the inguinal level to insert a catheter which will gain access to the femoral artery. The catheter then reaches the aneurysm and cuts off the blood supply to the aneurysmal sac by using a stent and embolisation agents. In case of a stroke, the catheter can be inserted from the femoral artery and passed through to the brain. Once it has reached the clot, the catheter releases a stent which will restore normal blood flow. When removing the stent, the clot will be removed as well. How can I prepare for it? You will need to have a few tests before an endovascular surgery, to make sure you don’t have any severe coagulopathies, as these could be life-threatening during the procedure. The surgeon and anaesthetist will also ask about your medical history to foresee any potential complications. Post-operative progress You will usually be able to home two days after the procedure. You should be able to go back to work after one week, but complete recovery takes roughly one month. It is important that you follow the doctor’s directions when it comes to which medications you can take and when you need to go for a follow-up appointment. Other treatment options Endovascular surgery may be recommended in conjunction with other types of treatment, depending on what cardiovascular condition you have. For example, in the case of a stroke, roughly one third of the cases can be treated with medication, although that only works if the clot is fairly small. ...

Endovenous laser treatment (EVLA)

What is endovenous laser treatment (EVLA)? Laser treatment for varicose veins is a minimally-invasive technique used in cosmetic surgery to treat varicose veins, which are dilations of the veins of the superficial and deep venous system located mainly in the lower limbs. This is a quick recovery technique that does not require hospital admission. It is less painful than conventional surgery and recovery time is shorter. It is performed under local anaesthetic and takes approximately 45 minutes. Why is endovenous laser treatment performed? Laser treatment for varicose veins is performed for one of two reasons: aesthetic or clinical. Laser treatment can be performed for cosmetic purposes, but it is mostly done for health reasons. This treatment helps to eliminate pain, swelling, bruising and a feeling of heaviness in the legs. It allows the blood to circulate through healthy veins, thus restoring the proper functioning of the circulatory system. What does endovenous laser treatment involve? Laser treatment for varicose veins consists of introducing a needle into the damaged vein and, using a guidewire, a laser fibre is then inserted through the needle. The laser transfers heat to the vein, sealing it closed, and this forces the blood to circulate through other deeper, healthier vessels. Although this type of treatment usually has very satisfactory results, there is, nevertheless, a risk of complications (thrombophlebitis, varicose vein haemorrhage or bleeding from a vein, or varicose ulcers). Preparing for varicose vein laser treatment: Preparation for laser surgery involves a study of your medical and family history. The doctor will ask questions about your symptoms, lifestyle and the veins to be treated. Post-treatment care: After treatment, you will be able to leave the clinic and resume your normal activities as long as they are not strenuous. You are advised to wear varicose vein stockings after the procedure and to take short walks every day. There is less postoperative swelling and bruising with laser treatment, as the walls of the varicose veins are targeted more precisely, so the surrounding tissue is not damaged. This allows for a faster and more comfortable post-treatment recovery. ...

Foam sclerotherapy

What is foam sclerotherapy? Sclerotherapy has been around as a treatment for a significant amount of time, and it involves injecting a special solution called a sclerosant into the vein, damaging the internal lining and creating a blood clot. The body then destroys the vein itself over time. With foam sclerotherapy, the solution is made into a foam by mixing it with a small amount of air and agitating the liquid. How does foam sclerotherapy work? In traditional sclerotherapy procedures, the blood can dilute the solution once it is injected into the vein. With a foam version of the solution, the air can in fact push the blood out of the way. The solution fills the vein, and stops when it comes into contact with larger veins, as it finally mixes with blood there and becomes ineffective. Over a short amount of time, the air in the solution leaves the injected vein, but the blood which was pushed aside sticks to the vein’s lining. This then blocks the vein off, effectively destroying it. How is foam sclerotherapy performed? The surgeon applies local anaesthetic to the area they wish to treat. They use an ultrasound scan to detect the exact positioning of the vein, and insert a needle into it. The sclerosant solution is then injected, and the surgeon can monitor progress on the screen. When enough foam has been injected, the needles are removed, and compression pads are applied to the leg. What is the aftercare for foam sclerotherapy? Bandages must be kept on for a few days. The patient then returns for a follow-up appointment, where the bandages and the compression pads will be removed. Sometimes patients need more than one session to completely remove the varicose veins, but usually when treatment is completed, the varicose veins will no longer be visible. Sometimes bruising occurs, but this is mild and usually goes away after a period of weeks. This is typical for most treatments of varicose veins. The patient can resume normal activity straight away, but is advised not to do vigorous exercise. This means patients can go back to work directly after the procedure, with little to no discomfort. ...

Hand veins

Visible or prominent veins in the hands are usually due to age, but other factors such as exercise or hot weather can influence the appearance. They can be removed by techniques like sclerotherapy or surgery. ...

Thrombosis

What is thrombosis? Thrombosis is the formation of a blood clot inside a vein which can obstruct the flow of blood throughout the body. There are two types of thrombosis: phlebothrombosis and thrombophlebitis. The first (phlebothrombosis) is the formation of a clot inside the vein, without inflammation but with a great capacity for detachment, given that it is poorly attached to the vessel wall. These types of blood clot usually affect the deeper venous system (deep vein thrombosis) and in bad cases can cause a stroke or a pulmonary embolism. In the case of thrombophlebitis, the clot is usually attached to the venous wall and results in swelling, tenderness and redness in the affected area of the body. Thrombophlebitis commonly affects the smaller, superficial veins in your legs. What are the symptoms of thrombosis? The symptoms of phlebothrombosis are: Swelling Pain Can lead to a pulmonary embolism The symptoms of thrombophlebitis are: Swelling and redness Some pain What causes thrombosis? Venous thrombosis is caused by either venous stasis (the slow movement of blood which can happen during long periods of immobility), hypercoagulability (an increased tendency for your blood to create clots due to an imbalance of clotting chemicals in the blood) or damage to the vein. There are also certain risk factors that can increase chances of a blood clot forming: Older age Pregnancy Certain contraceptive pills Hormone replacement therapy Immobility (travel, hospital stays, injuries) Obesity Smoking Leg injury Major surgery Inherited blood disorders You have had previous blood clots Can a thrombosis be prevented? The emergence of a thrombosis can be prevented by controlling the normal fluidity of the bloodstream and preventing the formation of clots. Therefore, in certain cases such as those recovering from surgery or when a person is bedridden for a period, the administration of heparin or oral anticoagulants are recommended. In general, it is recommended to drink large amounts of water and carry out certain exercises to contract the muscles of the legs and thus stimulate the flow of blood. There are also measures you can take to avoid a thrombosis forming: Keeping fit and exercising regularly Losing weight if you are overweight Eating healthily Stop smoking and drinking in excess If you sit for long periods, take regular breaks to walk around and stretch your legs Wear flight socks on long flights or car journeys (these can be bought from a pharmacy). How is a thrombosis treated? Treating a thrombosis depends on the patients overall health, age and medical history as well as the type of thrombosis detected. Treatment options include anti-coagulant medication (blood thinners), clot-dissolving medications, compression stockings and varicose vein removal. In patients with a thrombosis in the deep venous system of the leg (deep vein thrombosis), an emergency hospitalisation is required because if the clot detaches it, it could result in a pulmonary embolism or stroke. ...

Varicose veins surgery

What is varicose veins surgery? While more modern procedures such as sclerotherapy and ablation are generally favoured these days for the treatment of varicose veins, surgery is still an option in some cases. This type of surgery is usually called ‘ligation and stripping’. Varicose vein surgery is often carried out under general anaesthetic (which means you will not be conscious during the procedure). Why is it done? Varicose veins are often considered to be an aesthetic problem, but they can also cause pain and discomfort. Treatment is often advised by a doctor if varicose veins are uncomfortable and painful, or if they are related to other complications such as leg ulcers or discolouration in the skin. They can also be treated for cosmetic reasons, generally in a private clinic. What does it involve? Varicose vein surgery, or ‘ligation and stripping’ first consists of tying the vein in the leg, by making two small incisions in the leg. After these two incisions are made, the varicose vein is tied and sealed, and is then removed. Surgery usually takes around two to three hours, but you can generally go home after the procedure has been performed, after a short rest period in the clinic or hospital. How do you prepare for varicose veins surgery? You will first discuss treatment for varicose veins with a specialist to check that you are eligible for surgical treatment. Your specialist will advise you on any precautions you may need to take before the procedure, such as advising on medication you will not be able to take. Ask your surgeon if you will need to stay overnight in hospital, which is not common, but occurs in some cases. Check with your surgeon who will be performing the procedure and ask any questions you have about the procedure beforehand. Aftercare After the surgery, you will most likely have to wear compression stockings for a few days, or for up to a week. You will need to rest and elevate your leg whenever possible. Follow the advice provided by your surgeon. Generally, you will need some time off work to properly recover. This depends on the work which you do, and your health in general. Check with your surgeon when you will be able to return to work. Alternatives to this treatment Varicose veins can also be treated through foam sclerotherapy, radiofrequency ablation, and endovenous laser treatment. ...

Vascular trauma

Vascular trauma is any impairment on an arterial, venous or lymphatic level. The most common location is in the limbs and often associated with neurological damage to bones or limbs. The time between when the traumatic injury occurred to the start of treatment should be as short as possible to avoid serious complications. Among the most common causes of vascular injury are road accidents, domestic accidents, and work accidents. Vascular trauma can also manifest as spider veins, varicose veins, or telangiectasia, but the most important common symptom is bleeding. Physical and complementary examinations are crucial to diagnose and assess the condition of the patient to rule out other associated injuries such as to the chest, abdomen or skull/brain. It is also very important to maintain the vital functions of the patient and stop the bleeding with medical or surgical treatment. ...

Venous insufficiency

What is venous insufficiency? Veins in your legs have to carry blood back to the heart, and they can do this because the veins have one-way valves the stop the blood from flowing backwards with gravity. However, if you suffer from venous insufficiency these valves do not function properly and some of the blood remains in your legs which causes the blood to collect in the veins. This can result in pain and swelling, and sometimes leads to ulcers forming on the legs. What are the symptoms of venous insufficiency? The symptoms of venous insufficiency are: Itching and tingling Swelling Intense pain (which gets worse when stood upright or when someone is stationary) Heaviness or cramping in the legs In addition, there are also changes in the skin such as irritated or dry areas if scratched. Thickening and hardening of the skin (it can sometimes look leathery). Varicose veins What causes venous insufficiency? Venous insufficiency is due to malfunctioning vein valves in the legs. These valves can be damaged by blood clots (deep vein thrombosis, DVT). If you do not exercise much you can be at risk from venous insufficiency. Other risk factors include: People over the age of 50 Family history of venous insufficiency or DVT Being obese Being pregnant People who sit or stand for long periods of time Can venous insufficiency be prevented? The best way to prevent venous insufficiency is to make certain lifestyle changes: Losing weight Exercising regularly Consuming less salt in your diet (this reduces your blood pressure) Wearing compression stockings to help the blood in your legs flow better (these are recommended if you have suffered from DVT or had venous trauma). How can venous insufficiency be treated? As well as the above lifestyle changes, there are also medical treatments that can be recommended, particularly if these non-surgical measures have not proved successful. The following treatments might be recommended: Sclerotherapy Ligation (faulty veins are cut and tied off so that blood no longer flows through it) Vein repair Vein bypass Vein transplant Endovenous thermal ablation (high-frequency radio waves or lasers are used to close the faulty veins) ...

Venous ulcer

What are venous ulcers? Venous ulcers are sores that develop on the legs due to problems with blood circulation through the veins of the leg and minor injury. The problems with blood flow can result in blood pressure in the veins increasing which eventually damages the tiny blood vessels in the skin, which if knocked or scratched, can easily break and form an ulcer. What are the symptoms of venous ulcers? The main symptoms of venous leg ulcers are: Swollen ankles Pain and heaviness in the legs Brown spots on the legs Itchy, red skin on the legs Bad-smelling discharge from the ulcers Skin around the ulcer can be hardened If the ulcer becomes infected pain would worsen, discharge from the ulcer would be green and smell very unpleasant and you might have a fever. If infection occurs, medical attention is important. What causes venous ulcers? As mentioned, venous leg ulcers are caused by damage to tiny blood vessels of the leg skin, which when damaged results in ulcers. The risk factors for developing venous leg ulcers are: Obese and overweight people, as more pressure is on their leg veins. People who have difficulty walking as circulation in their legs is poor. People with varicose veins (caused by damaged vein valves). Older people Previous injury which limits movement and can cause deep vein thrombosis (DVT). Can venous ulcers be prevented? There are certain preventative measures, especially in those people who are predisposed to venous ulcers that can reduce the chances of ulcers forming, including: Hygiene – maintaining cleanliness of the legs and feet. Maintaining a healthy diet Compression stockings to help improve blood flow in the legs. Losing weight if you are overweight Treating underlying problems, such as varicose veins. How are venous ulcers treated? Venous leg ulcers can take up to four months to completely heal. The first step with an ulcer is clean and dress is properly, being careful that any dead tissue is removed. The next step is to improve the flow of blood using various compression techniques, such as compression bandages or stockings. Swelling caused by the ulcers in the feet and ankles (oedema) can also be controlled by compression bandages. Itchy skin around the ulcers can be improved using emollient cream or corticosteroid cream. Infected ulcers will be treated with antibiotics as well. ...

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Publications in the National Institute of Health

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Mr Ian Franklin
Vascular surgery
Central London

Mr Ian Franklin

Vascular surgeon in
London

MS FRCS

Mr Ian Franklin areas of expertise:

Professional statement

Videos of doctor

Credentials

Diseases, Medical Tests and Treatments

Deep vein thrombosis

Leg ulcers

Lymphoedema

Pelvic congestion syndrome

Spider veins

Varicose veins

Endovascular surgery

Endovenous laser treatment (EVLA)

Foam sclerotherapy

Hand veins

Thrombosis

Varicose veins surgery

Vascular trauma

Venous insufficiency

Venous ulcer

Other information about Ian Franklin

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Mr Ian Franklin Vascular surgeryCentral London

Mr Ian Franklin

Vascular surgeon in London

MS FRCS

Mr Ian Franklin areas of expertise:

Professional statement

Videos of doctor

Credentials

Diseases, Medical Tests and Treatments

Other information about Ian Franklin

Mr Ian Franklin
Vascular surgery
Central London

Vascular surgeon in
London