Materials and their distinctive characteristics of prosthetic venous valves used in primary chronic venous disease: current reservations and future perspectives
Konstantinos Spanos, MD, MSc, Athanasios Athanasoulas, MD, MSc, Christos Karathanos, MD, MSc, PhD, Nikolaos Rousas, MD, MSc, PhD, Athanasios D Giannoukas, MD, MSc, PhD, FEBVS.
Vascular Surgery Department, University Hospital of Larisa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece.
Abstract:
The prevalence of chronic venous disease in the adult population has been reported to be as high as 60%, particularly affecting populations in the developed world countries and in one third of cases the deep venous system is affected. Primary chronic deep venous insufficiency (CDVI) has been associated with important clinical and financial burden on the society. This pathology is related to venous valve dysfunction or obstruction leading to venous reflux and venous hypertension. In the long term, this may lead to varicose veins, chronic venous ulcers, and other related conditions. For patients with deep venous symptoms, the first line treatment is the conservative management such as compression therapy and ablative procedures. In cases in which the symptoms of the disease become persistent, various surgical reconstructions of the deep vein system have been developed. In those procedures the use of prosthetic venous valves have been introduced and evaluated in animal models and clinical studies. However, the results remain controversial and most of the valves have not performed as they were expected. Recenlty, a new idea has been introduced for primary CVDI treatment because of the evolution of endovascular techniques, thus, implantable valves with endovenous approach have been proposed as the treatment option for primary CVDI therapy. In the future, primary CVDI is expected to be treated mostly by percutaneously implanted valves. There is still though a debate for what should be the indications and what difficulties should we confront in ideally designing and developing them.
Key words: Prosthetic venous valve, primary chronic deep venous insufficiency, endovenous