Chronic venous insufficiency more common in women

President Donald Trump’s recent diagnosis of chronic venous insufficiency (CVI) has brought renewed medical attention to a condition affecting lakhs of Indians as experts highlight emerging treatment options that could improve outcomes for patients battling this common, but often misunderstood vascular disorder. This can be present in the form of varicose veins, venous ulcers or post thrombotic syndrome.

On July 17, President Trump was diagnosed with CVI after experiencing mild swelling in his lower legs. The diagnosis, confirmed through comprehensive vascular studies, including bilateral lower extremity venous doppler ultrasounds, revealed the condition commonly seen in individuals over 70, although people of any age can be affected with it.

“Chronic venous insufficiency occurs when veins in the legs fail to efficiently return blood to the heart due to damaged or weakened valves, causing blood to pool in the lower extremities,” said Dr Pawar.

He further added that the condition progresses through six clinical stages, from asymptomatic spider veins to active ulcerations. Common symptoms include leg swelling, aching, cramping, varicose veins, skin discoloration, and in advanced cases, venous ulcers that are difficult to heal. Without proper treatment, CVI can lead to serious complications, including cellulitis, leg ulcers or deep vein thrombosis.

Dr Pawar said that risk factors for CVI include advanced age, female gender, obesity, pregnancy, prolonged standing or sitting, smoking and family history of venous disease. The condition is twice as common in women as men, with 37% of adults estimated to have some form of chronic venous insufficiency.

Modern CVI management has evolved dramatically from traditional surgical interventions to minimally invasive procedures that offer superior outcome with reduced recovery time. Treatment approaches now encompass conservative management, advanced compression therapies and cutting-edge endovenous procedures, he says.

Endovenous laser ablation (ELA), radiofrequency ablation (RFA) and glue therapy have largely replaced traditional surgical stripping procedures, offering high success rates with minimal complications. These ambulatory procedures use local anesthesia and require no sedation, allowing patients to resume normal activities immediately.

While cautioning, Dr Pawar said that the important point is to get treatment done by the right experts in this field.

Conservative management remains crucial for all CVI patients, with lifestyle modifications proving effective for symptom control and disease progression prevention. Regular physical activity, particularly low-impact exercises like walking, swimming and cycling, improves blood circulation and strengthens calf muscle pump function.

Weight management reduces venous pressure, with obesity representing a significant modifiable risk factor. Leg elevation above heart level for 15-20 minutes multiple times daily provides immediate symptom relief. Seeking prompt and early treatment can help to avoid major surgery, says Dr Pawar.