The term venoplasty relates to modalities reducing the diameter of enlarged veins. We investigate options to achieve temporary or long-term effects by ultrasound-guided perivenous injection of hyaluronan. Dependent on target and purpose, different types (viscosity, durability, cost per ml) of hyaluronan may be applied.
Major indications are:
1) Replacement of tumescent anesthesia
The effect of tumescent fluids will vanish within days and complaints due to regression of re-filled large veins are frequent. When chosing hyaluronan of 6 - 8 weeks half life, the compression effect will last long enough to provide a symptom-free postinterventional period. No more discolorations after Laser/RF. No compression stockings required.
2) Vein diameter corrections during occlusive treatments
Example: When closing a refluxive accessory anterior saphenous vein, the diameter of the common GSV segment will often be large. It´s diameter should be adapted to the flushing rate of GSV and epigastric vein to prevent relapse or thrombosis.
Another application is to temporary "block" a vein, e.g. to limit sclerofoam propagation.
3) Hemodynamic modifications
By long-lasting perivenous hyaluronan depots, pressure and thus blood volumes of superficial varicosities can be modified, leading to total disappearance while maintaining a natural flow.
Ragg JC. US-guided perivenous hyaluronan injection or saline tumescence
Vein Therapy News 12/2015-01/2016