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04. From Sclerotherapy and Ablation Surgery to Phlebotherapy (TRAP): key concepts

Varicose veins that are visible to the naked eye, on transillumination or by means of near-infrared reflection and absorption techniques, constitute only the effect of varicose disease. To cure varicose disease, we have to treat the cause; this can only be done by regenerating the vessel walls. Regeneration means restoration of the altered vascular structure and function.
Current sclerotherapy treatments, phlebectomy and functional ligature are irrational because they are two-dimensional techniques which act on the effect of the disease, not on its cause. Such treatments, which are not free from side-effects, destroy the normal anatomy of the veins and cannot achieve the desired result: the disappearance of all the visible veins and the functional recovery of the venous circulation.

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03. Case report: Three-dimensional Regenerative Ambulatory Phlebotherapy for incontinent perforating veins in patients who have already undergone multiple phlebectomies

This patient had undergone a bilateral saphenectomy of the great saphenous vein and multiple posterior phlebectomies in both calves. In the treated areas, new varices had formed owing to the persistence of perforating veins in the regions involved. Incontinent veins had been inadequately treated by phlebectomy which, as is known, has a mainly two-dimensional action. Incontinent perforating veins had given rise to new evident venous ectasias. We viewed the sites of venous reflux by means of a spectroscopic analysis method. During the analysis, significant venous reflux was seen in the perforating veins of Cockett, Sherman and Boyd in the left leg. In the right leg, the perforating veins of Sherman and Boyd were seen to be incontinent and bulging. Numerous posterior bilateral perforating veins were seen to be feeding large varices with significant reflux.

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02. A venous ulcer cured by a single treatment of TRAP

Three-dimensional regenerative ambulatory phlebotherapy (TRAP) treats the walls of the veins and restores functionally correct circulation. The solution used, which is injected through the vessels is visible to the naked eye or on transillumination, reaches the perforating veins, reducing their diameter, strengthening the vessel walls and restoring continence. The recovery of haemodynamic and hydrostatic functions enables venous ulcers to heal rapidly. Reducing excessive capacity alleviates pain and eliminates the sensation of heavy legs. In the case described here, haemodynamic hypertension had acted locally to create trophic lesions, which gave rise to an ulcer. Caused by an incontinent perforating vein, the ulcer had been present for more than a year. After a single treatment of TRAP, it healed within three weeks.

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01. Tree-dimensional regenerative ambulatory phlebotherapy (TRAP) a new concepts for treating varicose disease

Three-dimensional regenerative ambulatory phlebotherapy (TRAP) is a technique of non-obliterative injection which acts on the perforating and superficial circulation. It “cures” varicose disease of the lower limbs by strengthening the vessel walls, shrinking the lumen, restoring valvular function and causing all visible vessels to disappear, whether they be varicose veins, spider veins or telangiectasias. To describe these effects, we use the term “regeneration.” This term highlights the restoration of the vascular structure.