Permitting physicians to advertise opened the door for some among (the worse off) us to abuse this privilege. This abuse was and still is especially true when it comes to exaggerated, false and unrealistic claims of the results of injection sclerotherapy for truncal varicose veins. The reason is simple: professional and also financial gain. Please remember that the failure (recurrence) rate of this approach is a whopping 60-80%!

In my geographic area the championship belonged for many years to Vein Clinics of America (VCA). After years of false advertising, they were finally cited in an official document by the Federal Trade Commission(FTC) in January 1994. A sample of their false advertisement [fig.1] together with the FTC document and the signature on it of the founder and owner of this setup, Brian McDonagh is made public here [fig.2-3]. While this "McDonald's" type chain clinic has closed its doors in Southern California, they are still active in several states of the union. The following physicians were listed on VCA letterheads and were associated with this misleading organization: Deborah P. Foley and Mark Forrestal (formerly from Beverly Hills and Chicago); Terrence Walsh (Atlanta); Jan V. Karlin (Encino-Los Angeles); Allan J. Ebbin (from Encino-Los Angeles); Robert Dole (Arcadia and Irvine, CA); Alan Kanter (Irvine and Torrance, CA); Michael Landau (Beverly Hills) Mark N. Isaaks (Walnut Creek, CA); just to name a few.

It is unfortunate that even today, in February 1996, some of the practitioners still disregard the evidence against this form of treatment and keep misleading physicians, the public, and themselves by trumpeting excellent results of... 90% success rate...This is the case of The Vein Center of Irvine and Torrance California that uses the Los Angeles as well as Orange County Medical Associations bulletins for false and misleading advertisement [fig 4-5]. Not surprisingly the physician, Alan Kanter, is a former VCA employee/associate...

Unfortunately even a professional organization such as the North American Society of Phlebology (NASP) can be linked to disseminating similar false information regarding the same topic: sclerotherapy for varicose veins. Robert M. Weiss, a leader member of the organization using his academic title of assistant professor of dermatology from the prestigious Johns Hopkins University from Baltimore was quoted in trumpeting over the pages of the tabloid Enquirer of June 1993 that you can get rid of varicose veins without surgery thanks to a painless 15 minute techniques that is done in a doctor's office... and later... "called echosclerotherapy... you can eliminate the varicose veins in one or two treatments". At the end of this well orchestrated infomercial the naive reader is referred to the offices of the NASP organization (telephone provided) to obtain the name and address of a doctor qualified to perform echosclerotherapy (i.e. duplex guided injections) (fig 6). It is not just a simple coincidence, therefore, that the same physician is a coauthor of the review article to which I targeted my reply in the form of a Letter to the Editor.

Please be reminded that the newest 1996 Medicare Directives is clearly stating that injection sclerotherapy has a 60-80% failure rate. Moreover, the Handbook of Venous Disorders-Guidelines of the American Venous Forum published by Chapman &Hall; Medical also in 1996 states that sclerotherapy for varicose veins with communication to a source of reflux (reversed flow) as depicted by ultrasound examination will fail (page 399) and is therefore contraindicated ( page 343).