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chronic venous insufficiency

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Interim two-year follow-up data from the VenoValve pivotal trial were presented at the Society for Vascular Surgery 2025 Vascular Annual Meeting. In this trial of 42 subjects with severe chronic venous insufficiency (CVI), 83.3% maintained clinically meaningful benefit after 24 months, defined as an improvement of 3 or more points in the revised Venous Clinical Severity Score (rVCSS). The responder cohort saw an average rVCSS improvement of 9.1 points and a median 74% improvement in leg pain. Among 17 subjects with 25 leg ulcers, 60% of ulcers fully healed, 24% improved in size, and 16% worsened. Patient-reported outcomes confirmed sustained enhancements across all venous-specific quality of life indicators. Importantly, all 30 subjects tested had a 100% valve patency rate at 24 months. These results are especially notable as all patients had severe, treatment-resistant CVI, suggesting the VenoValve procedure could alter the paradigm for managing deep venous CVI[1].

Recent research highlights emerging pharmacologic therapies for CVI, evaluating agents like hydroxyethylrutoside and Pycnogenol. These drugs demonstrated significant benefits in pain reduction and resting blood flow, though improvements in edema and quality of life were more variable. While hydroxyethylrutoside and Pycnogenol appear promising, study limitations, such as heterogeneity and small sample sizes, indicate a need for more robust and standardized clinical trials before widespread adoption. The importance of tailored, cost-effective CVI strategies is also emphasized, particularly in settings with limited resources[2].

Artificial intelligence (AI) is showing potential to enhance the diagnosis and management of venous diseases, including CVI. Studies have explored AI’s ability to classify disease severity across the full spectrum of the clinical–etiology–anatomy–pathophysiology (CEAP) framework, from early to advanced cases and acute complications like thrombosis. These efforts suggest that AI could support more precise and scalable clinical decision-making in venous disease, but further validation and integration into practice are needed[3].

Minimally invasive techniques—such as radiofrequency ablation (RFA), endovenous ablation, and sclerotherapy—are now established as effective CVI treatments and offer quality-of-life outcomes comparable or superior to traditional surgery. Studies indicate that combining RFA with sclerotherapy can further speed recovery and reduce costs and hospital stays, with permanent vessel occlusion achieved in the vast majority of cases. Overall, these minimally invasive options tend to have lower recurrence rates and are cost-efficient alternatives to historical open surgery[6].

The latest clinical guidelines, updated in early 2025 by major vascular societies, continue to endorse ultrasound for patients with symptomatic disease, recommend compression stockings and select supplements for mild cases, and support minimally invasive interventions for varicose veins. Comprehensive, multidisciplinary research priorities were also highlighted at recent international conferences, pointing to the need for greater funding and focused research to address CVI’s growing impact on patient quality of life and healthcare costs globally[5][7].

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