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As an adjuvant to sclerotherapy or thermoocclusion, the reduction of target vein diameter is often desired. Another aim is to restore dilated valve regions. Can this be accomplished by perivenous fluid injections? We examined a new modality which was created for this purpose.
The IntraShape® device consists of a safety injection cannula and a viscous fluid containing native hyaluronic acid and a moderately cross-linked hyaluronic acid (2%, 1:10 - 1:1). The cannula is advanced to a extravenous tip position, then the sharp tip is changed to blunt so further movements cannot penetrate the vein wall while the viscous fluid is distributed under ultrasound monitoring. The device was used 1/2013 - 8/2013 in 178 patients with varicosities (diameter 7.1 - 24.8 mm) with injected volumes of 12 - 48 ml.
In one group (n=98), aiming at adjuvant diameter reduction during sclerotherapy, the treated segment (length 7 - 14 cm) was totally free of complaints, opposite to phlebitic complaints in 47/88 comparable segments without adjuvant treatment. In the second group (n = 80), aiming to valve function restoration, in 62/80 cases the reflux could be stopped during follow-up of 6 months. There were no adverse reactions.
IntraShape® is a safe and effective modality to reduce the diameter of enlarged veins and to restore incompetent vein valves. The long-term effect depends on the quantity of cross-linked hyaluronan, which increases the costs. As the method does not require any compression means it is well applicable in patients with severe peripheral arterial disorders.