The term venoplasty relates to methods reducing the diameter of enlarged veins. We are investigating 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 choosing hyaluronan of 6 - 8 weeks half-life, the compression effect will last long enough to provide a symptom-free postintervention period. No more discolorations after Laser/RF. No compression stockings required.
2) Vein diameter corrections during occlusive treatments
Example: when closing a reflexive 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 temporarily ‘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 complete disappearance while maintaining a natural flow.
Ragg JC. US-guided perivenous hyaluronan injection or saline tumescence
Vein Therapy News 12/2015-01/2016