Veins in the spotlight: Understanding chronic venous insufficiency

 What is chronic venous insufficiency?

Chronic venous insufficiency (CVI) is a circulatory condition in which the venous valves in the legs become weakened or damaged, impairing their ability to keep blood flowing upward toward the heart. As a result, blood tends to pool in the lower legs, increasing venous pressure and causing various symptoms such as swelling and leg ulcers.

Why is CVI in the news right now?

The CVI has garnered attention due to the recent diagnosis of US President Donald Trump. After visible leg swelling and bruising spurred public speculation, the White House confirmed in mid-2025 that he had been diagnosed with CVI — a condition considered common and non–life-threatening, especially in older adults. Tests ruled out more serious issues such as DVT or arterial disease.

Causes of CVI

• Key factors contributing to CVI include:
• Valve damage in deep, superficial, or perforating veins that hinder proper one-way blood flow
• Deep vein thrombosis (DVT), which can injure valves and lead to CVI
• Genetic predisposition (congenital issues), aging, and hormonal changes (especially during pregnancy)
• Lifestyle and health factors, such as obesity, long periods of sitting or standing, smoking, and high blood pressure
• Leg injuries or surgeries, which may damage venous structures

Common symptoms of CVI

• CVI often develops gradually and may include:
• Swelling (especially in the ankles and lower legs) and a sensation of heaviness
• Leg pain, cramping, tingling, or restless legs that may worsen when standing and improve with elevation
• Appearance of varicose veins — twisted, bulging veins near the surface
• Skin changes, including itching, discoloration (reddish-brown), flaky or leathery texture, and, in advanced cases, ulcer formation
• If untreated, continuous venous pressure may lead to serious complications like chronic ulcers, infections, or bleeding

Surge in media coverage & awareness

This news sparked widespread media coverage and public interest in understanding what CVI is, how it's managed, and why it matters. Medical experts and organisations like the American Heart Association have used this moment to educate the public about its prevalence and risk factors.

Advances in management and guidelines

Additionally, the Society for Cardiovascular Angiography & Interventions (SCAI) recently released new evidence-based clinical guidelines for managing chronic venous disease, covering therapeutic options from compression therapy to surgical interventions—highlighting ongoing efforts to standardize and improve patient care. Emerging surgical approaches, including innovative minimally invasive techniques, are also advancing, with figures like the SAVVE venous valve endoprosthesis offering promising results in clinical trials.