Prosthetic venous valves for chronic venous insufficiency: Advancements and future design directions

With the serious aging population and lifestyle changes, chronic venous insufficiency accounts for approximately 25.95% of the population, which may lead to lower limb edema and leg heaviness, as well as severe infections of skin ulcers that can result in sepsis and necessitate amputation. Conservative treatment and other supportive measures can only slow the disease's progression but are unable to drastically reverse it; surgical interventions are rarely used due to the high risk of catastrophic postoperative consequences. As one of the most promising minimally invasive therapies, percutaneous prosthetic valve replacement has emerged in light of this situation, providing novel alternatives for patients with deep venous valve insufficiency. We reviewed the historical prosthetic venous valve designs, including their structure and materials, animal evaluation models, and assessment criteria. On the basis of the findings from in vitro tests, animal studies, and clinical trials, we summarized the major challenges and potential solutions for the development of advanced prosthetic venous valves.