Director angioclinic vein centers Berlin, Berlin, Germany
Objective: In the past, venous insufficiency of the lower extremities was thought to be an acquired disease of adulthood, mainly determined by genetic predisposition. Since 2018 studies using high-resolution ultrasound have shown that more than 40% of children already have more or less relevant venous valve defects, which are most likely congenital. We examined a subgroup of study participants from 2017 - 2018 with a follow-up of at least 4 years.
Methods: Of 65 children and adolescents between the ages of 6 and 18 first examined in 2017 and 2018, n = 35 (18w, 17m) underwent a follow-up examination of leg vein status after 4 years using the same high-resolution ultrasound systems (16 – 23 MHz).
Results: All subjects remained asymptomatic. A functional progression was found for 27/35 (77.7%), in particular, lengthening of the reflux path (10/27; 37.0%), increase of the reflux duration with an unchanged reflux path (8/27; 29.6%), enlargement of the valvular leak in the case of a commissural defect (5/27; 18.5%) and occurrence of additional findings (e.g., perforating or side branch reflux, 4/27; 14.8%).
Conclusions: Valve defects in children are not only much more common than previously expected, they also show determinable progression over a four-year period, with relevant interindividual variations. Thus, leaking vein valves of the intrafascial and epifascial systems should be regarded as a disease in asymptomatic early stages, and researched to develop effective and cost-saving prevention strategies.