Progression in venous pathology.
OBJECTIVE
To review epidemiologic data on progression of venous pathology in varicose veins and from varicose veins towards chronic venous insufficiency.


METHODS
We searched Medline and PubMed for epidemiologic studies concerning progression of venous pathology.


RESULTS
The data suggest that reflux progression may develop from segmental to multisegmental superficial reflux. In younger age, reflux in tributaries and non-saphenous veins is more frequent. In older age, more saphenous reflux develops and more proximal sites seem to be affected. A high proportion of uncomplicated varicose vein (C2) develops skin changes and chronic venous insufficiency (C3-C6). Significant risk factors for the progression of varicose vein towards venous leg ulcers are skin changes, corona phlebectatica, higher body mass index and popliteal vein reflux. During a 13.4-year follow-up period, 57.8% (4.3%/year) of all chronic venous disease patients showed progression of the disease.


CONCLUSIONS
Studies on the progression of venous pathology show a high progression rate of chronic venous disease. More follow-up studies are still needed to get better information about the risk of varicose vein patients for progression to venous leg ulcers and to answer the question which patients may benefit from early varicose vein interventions.
Private Practice Phlebology & Dermatology, Bonn, Germany info@dr-pannier.de.
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F
Pannier
Department of Dermatology, University of Bonn, Bonn, Germany.
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Rabe
D000367:Age Factors; D015992:Body Mass Index; D018450:Disease Progression; D006801:Humans; D014647:Varicose Ulcer / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D014689:Venous Insufficiency / Q000150:complications / Q000473:pathology / Q000503:physiopathology
Varicose veins; chronic venous insufficiency; progression; reflux; venous pathology