Chronic insufficiency of lower extremity venous valves represents a frequent structural disorder of the vascular system being responsible for a substantial global disease load. While in the field of superficial valve insufficiency surgical as well as endoluminal interventions represent good therapeutic options with high rates of complete remission of symptoms, only limited options exist in the field of deep venous reflux today. Bioengineered, autologous cell-based, endothelialized valve constructs may open up new therapeutic options in these patients, potentially offering novel treatment options in cases with severe insufficiency of deep venous segments in the future. Areas covered: This review summarizes previous reports focusing on venous valve replacement and bioengineering, also including first preclinical in vivo studies and first clinical trials in patients. In particular, the aspects of current technical and medical limitations of venous valve bioengineering approaches preventing clinical translation and potential solutions by upcoming technologies will be discussed as part of this review. Expert commentary: Bioengineered replacement valves may open up novel options in the treatment of venous valve disease in defined patient groups in the future. However, preventing thromboembolic complications will remain the bottle-neck for clinical translation of the technologies involved.
Keywords: Vascular bioengineering; chronic venous disease; reflux; thrombogenicity; venous valve replacement; venous valves.