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Updated: May 23, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Ultrasound-Guided Extraluminal Venous Valve Functional Remodeling
Weipu Zou1, Meijia Xu2, Qianqian Jia3
1Department of Ultrasound in Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Background:
Endovenous treatment for varicose veins is predominantly ablative, whereas vein-preserving approaches remain limited.
Case Summary:
A 60-year-old man with left lower extremity varicose veins and pruritus underwent ultrasound-guided extraluminal circumferential hyaluronic acid injection around the incompetent terminal valve at the left saphenofemoral junction after duplex ultrasound confirmed primary superficial venous valve incompetence. Immediate and early follow-up duplex ultrasound showed abolition of reflux, with brief reflux <0.5 seconds at 3 months and recurrent reflux >0.5 seconds at 12 months. No procedure-related complications occurred.
Discussion:
This case documents immediate and stage-dependent changes in venous valve behavior after a vein-preserving extraluminal intervention and highlights the role of duplex ultrasound in guidance and serial assessment.
Take-Home Messages:
Extraluminal intervention may induce short-term changes in reflux without vein ablation. Durability and clinical significance require further study. (Feasibility Study of Ultrasound-guided Functional Remodeling of Lower Extremity Superficial Venous Valve; NCT05914740).
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