Five-year results of incompetent perforator vein closure using TRans-Luminal Occlusion of Perforator

Abstract

Despite these results representing our learning curve for the procedure, we found TRLOP to be an effective treatment for IPVs. The closure rates described are comparable with the published clinical series data for subfascial endoscopic perforator surgery.

Part One: For the Motion. Venous Perforator Surgery is Proven and Does Reduce Recurrences

“…18 TRLOP described the method of percutaneous cannulation of an IPV under ultrasound guidance through a single-needle hole, so that any treatment catheter can be passed into it for thermal or nonthermal ablation. The success of TRLOP at 1 and 5 years was the same or better than that reported for SEPS, 19,20 and encouraged others to "reinvent" and attempt to rename the TRLOP technique. Since the original descriptions of TRLOP in 2002 and 2004, terms such as perforator ablation procedure, 21 ultrasound-guided percutaneous ablation, 22 and other descriptive terms or device names have appeared, 23 although none have added anything to the original description of the TRLOP technique from 2002 and 2004.…”

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

“…23,[342][343][344][346][347][348]350 Therapy can be repeated with ease, risk of complications is minimal, and early to midterm results in case series are equivalent to or better than those reported after conventional perforating vein interruptions. [356][357][358] The risks of open procedures, which specifically include infection, difficulty in healing of incisions required for treatment, increased local trauma, and need for general anesthesia, set open operations apart from these less invasive percutaneous methods.…”

“…[339][340][341][342][343][344][345][346][347][348][349][350][351][352] The Dutch RCT comparing subfascial endoscopic perforator vein surgery (SEPS) with or without superficial reflux ablation to medical treatment in patients with venous ulcers found no difference in healing rate or recurrence in the two treatment groups. 317 However, patients with recurrent ulceration or medially located ulcers in the surgical group had a longer ulcer-free period than did those treated in the conservative group (P ¼ .02).…”

Current state of the treatment of perforating veins

“…Failure of perforator closure has been predicted by anticoagulation, obesity, and venous pulsatility. 24,25 Long-term closure rates are significantly lower compared with those of saphenous ablation; approximately 80% of immediately thrombosed perforators are closed 1 year later. 22,34 Perforator anatomy may partially explain decreased closure rates.…”