Hemostasis Today
NewsFeed
Headlines Hematology Health Medicine VTE ASH Plasma Donation
September, 2026
September 2026
M T W T F S S
 123456
78910111213
14151617181920
21222324252627
282930  
Alastair Lewis: Powerful TIRS Outcomes in Venous Ulcer Prevention
Alastair Lewis/LinkedIn
Nov 28, 2025, 16:20

Alastair Lewis: Powerful TIRS Outcomes in Venous Ulcer Prevention

Alastair Lewis, Vascular Surgeon at Fitzwilliam Health Clinic, posted on LinkedIn:

”Terminal Interruption of Reflux Source (TIRS) in pre-ulceration.
54-year-old male, 6-month history of progressive swelling, itch, and evolving skin change,s and 3-4 week active flare-up of LDS in the right pre-tibial area. History of EVLT and healed venous ulcer, left leg in 2022.

Duplex findings

  • Great saphenous vein 8mm in thigh, 5mm in calf.
  • 4-5mm varicosities arising from GSV tributaries.
  • Extensive venous plexus underlying LDS

Treatment

  • Single session of ultrasound-guided foam sclerotherapy performed in a peripheral-to-proximal manner.
  • 8mls 0.2% Varixio STS foam to sub-LDS plexus
  • 8mls 0.5% Varixio STS foam to the varicose veins and calf segment of GSV
  • 4mls 3% STS foam, physician-compounded, thigh GSV
  • Class 2 compression stockings for 2 weeks

Outcome

  • Immediate relief of itch and swelling 24 hours following treatment.
  • 8 week review – duplex confirms occlusion of GSV, varicose veins, and sub-LDS plexus
  • Clinically – almost complete resolution of swelling, inactive skin changes remain
  • This experience underscores the value of early intervention for venous disease complications and highlights the effectiveness of targeting peripheral venous plexuses in patients at risk of ulceration.”
  • Alastair Lewis: Powerful TIRS Outcomes in Venous Ulcer Prevention Ulcer

Stay updated with Hemostasis Today.

Alastair Lewis Fitzwilliam Health Clinic Health Hematology Hemostasis Hemostasis Today Medicine sclerotherapy Terminal Interruption of Reflux Source thrombosis TIRS Ulcer Ulcer Prevention Vascular Surgery Venous Disease Venous Ulcer Prevention
NewsFeed