Short Biography Information
Dr. Enric Roche is an angiologist and vascular surgeon with extensive experience in angiology, vascular surgery and minimally invasive venous interventions. He currently serves as a staff physician at Hospital Universitario General de Cataluña and is the Director of Clínica Vascular Barcelona, a multidisciplinary vascular centre specialising in non-surgical and minimally invasive treatments for venous disease. Dr. Roche is also the Medical Director of VB Devices, a medical technology start-up focused on the development of innovative vascular and endovascular devices.
Dr. Roche has played a pioneering role in Spain in the introduction and dissemination of minimally invasive treatments in phlebology. Between 1999 and 2015, he led the Vascular Surgery Department at Hospital Plató, which became the first public healthcare centre in Spain to incorporate endoluminal techniques such as endovenous laser treatment (EVLT), radiofrequency ablation (RFA) and ultrasound-guided foam sclerotherapy (UGFS) for the management of varicose veins. During this period, he was also actively involved as an instructor in emerging venous technologies, including Trivex, mechanochemical ablation systems (Clarivein, Flebogrif) and advanced foam sclerotherapy techniques.
In 2012, Dr. Roche founded Clínica Vascular Barcelona, establishing a dedicated private vascular centre offering comprehensive services in angiology and vascular surgery, with a strong emphasis on minimally invasive and outpatient-based treatments. From April 2015 to 2023, he served as Head of the Vascular Surgery Departments at both Hospital Universitari Sagrat Cor and Hospital General de Cataluña, institutions equipped with advanced technologies for the management of complex vascular pathologies, including aortic aneurysms, carotid artery disease and chronic venous disorders.
In April 2023, Dr. Roche stepped down from his departmental leadership roles to focus on innovation and highly specialised clinical projects, particularly in the field of abdominopelvic venous pathology. He continues to develop Clínica Vascular Barcelona, collaborates closely with Hospital Universitari Josep Trueta in Girona, and maintains his consulting role at Hospital General de Cataluña. In parallel, he serves as a medical–legal consultant for the Barcelona Medical Association (Col·legi de Metges de Barcelona).
Dr. Roche has also made significant contributions to medical innovation. Since 2013, he has developed three families of patents in endovascular procedures and sclerotherapy, including the first dedicated device for the preparation of sclerosing foam (Varixio®). In 2016, he founded Vascular Barcelona Devices (VB Devices) to translate these innovations into clinical practice. Today, VB Devices’ technologies are used by clinicians in more than 40 countries worldwide, reflecting his ongoing commitment to advancing venous care through innovation, education and global collaboration.
Interview questions:
Can you describe a particularly difficult case you have encountered in your practice as a phlebologist and how you dealt with it?
Two different cases. The first was a 91-year-old female patient with very painful bilateral venous ulcers who was initially deemed unsuitable for any treatment except topical wound care. After several sclerotherapy sessions on the trunk veins and sub-ulcer bed, they healed after four months of treatment. The second was a 63-year-old male patient, an athlete and very active, with truncal varicose veins and venous hypertension who had suffered a femoropopliteal venous thrombosis. I faced the dilemma of whether or not to treat the superficial venous system or to pursue a conservative approach with compression and venotonics. I ultimately decided to perform endothermic treatment of the great saphenous vein combined with foam sclerotherapy on a major perforating vein that was insufficient. Two months after treatment, the patient was back playing tennis and skiing, only requiring compression therapy.
What new developments or advances in venous surgery are you most excited about, and how do you think they will improve outcomes for patients?
A few years ago, I commented in a vascular surgeons’ forum that varicose vein surgery would eventually disappear. I don’t know when but I still believe this, and treatments like HIFU, cavitation ablation, and the global growth of sclerotherapy point in that direction. Although I still perform some cases in the operating room using endothermic techniques, they are becoming less frequent, and technology will allow us to treat any type of varicose vein painlessly in the office.
What advice would you give to patients who are considering vein surgery, and how can they prepare for the procedure and recovery?
Patients today have access to a lot of information on social media. I would advise them to seek information from professional sources that don’t offer miracle cures. Don’t be swayed by offers, and if you have any doubts, always seek a second opinion. Today we can offer minimally invasive techniques, but we mustn’t forget that vein ablation will always cause some inflammation.
In your opinion, what distinguishes phlebology from other surgical specialties, and what attracted you to this field?
Over the last 20 years, phlebology has experienced significant development and enrichment in many aspects. The understanding of venous hemodynamics, facilitated by the use of Doppler ultrasound, has provided us with an irreplaceable tool. This allows us to offer minimally invasive treatments based on new technologies that address previously untreatable clinical situations, alleviate the suffering of many patients with chronic pelvic pain that was traditionally ignored, and improve the quality of life for patients with post-thrombotic disease. These advances sometimes lead vascular surgeons to abandon arterial surgery in order to focus on venous patients.
How do you see the future evolution of phlebology and what role do you think technology and innovation will play in this evolution?
As I’ve already mentioned, it seems clear that technology based on minimal invasiveness, versatility, and the ability to perform procedures in a comfortable and virtually painless environment will be the future. Health authorities and companies in the healthcare sector will need to evolve and recognize that certain initial costs can be more than offset by savings in sick leave and other advantages offered by these treatments.
