[An epidemiologic study of the pathogenesis of varices. The Bochum study I-III].

A longitudinal study was carried out at 11 secondary schools (Gymnasium) of the city of Bochum to investigate the early and preclinical stages of developing varicose veins. The same pupils were examined when being in the 5th, 9th, and 13th classes (Bochum Study I, II and III). A significant correlation between familial predisposition and the occurrence of varicose veins could not be found until the Bochum Study III. The girls dominated with respect to reticular varices and telangiectasias, the boys with respect to trunk varices, branch varices and incompetent perforators. Photoplethysmography showed shorter refilling times for children and adolescents than for adults, but was not suitable to distinguish between pathological and normal findings. Large varices appeared later than small varices and were preceded by refluxes of the long and short saphenous veins. We thus have for the first time a preclinical sign, which clearly identifies individuals at risk.