Percutaneous valvuloplasty – the first method 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 fixing enlarged valve zones to a regular diameter surgically by use of tissue cuffs or coats, surrounding the vein like a corset). The idea of a complete vein-preserving treatment is fascinating. It seems to help patients in early stages of vein insuffiency, or those with arterial problems (preserving veins for potential bypass). However, extraluminal stenting is open surgery with all the associated surgery-related risks (wound infection, tissue damage), furthermore requiring general anesthesia.
Based on the encouraging results from 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 were completed 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 took place at the end of 2017.

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