**9. Conclusion**

Since its first description in 1992, TPVL has undergone an important evolution and become a confirmed technique. It is currently considered as a first-line and vital solution for PVLs reduction by many teams, even if surgery remains the reference technique in guidelines. It is important to note that it demands high expertise and is feasible only in Ref. centers with a multidisciplinary team contribution. It remains limited by dedicated devices availability and lack of financial support.
