Percutaneous valvuloplasty – the first modality to restore insufficient veins without surgery
Almost all surgical or endovenous vein treatments are destructive. In the last decade, there was only one exception: Extraluminal stenting. This means to fix enlarged valve zones to a regular diameter surgically by use of tissue cuffs or coats, surrounding the vein like a corsett). The idea of a totally vein-preserving treatment is fascinating. It seems to help patients in early stages of vein insuffiency, or such with arterial problems (preserving veins for potential bypass). However, extraluminal stenting is open surgery with all surgery-related risks (wound infection, tissue damage), furthermore requiring general anaesthesia .
Based on the encouraging results of extraluminal stenting, all based on low level ultrasound diagnosis of former generations, we developed a method to shape dilated vein valve zones by injections with hyaluronan. A few cases with exceptional indications could be done in 2013, proving feasibility and safety (UIP Poster Prize, Boston 2013). Further tests 2014-2016 have shown which kind of hyaluronan (viscosity, particle size) is the most suitable for this purpose.
A final approval study will be started at the end of 2017.
Ragg JC in: Charing Cross Symposium Book 2017 BIBA Medical
Ragg JC. Percutaneous valvuloplasty by injection of hyaluronan gel
VascularNews 9/2015 - report from EVF St. Petersburg 2015