UNRAVELING CHRONIC VENOUS INSUFFICIENCY: CLINICAL PROFILES, VENOUS PATHOPHYSIOLOGY, AND THE ROLE OF ENDOVENOUS LASER ABLATION

Introduction: Chronic venous insufficiency (CVI) is a progressive manifestation of chronic venous disease driven by sustained venous hypertension, commonly caused by superficial reflux and valvular incompetence. Endovenous laser ablation (EVLA) is a key minimally invasive treatment for symptomatic truncal reflux, particularly great saphenous vein (GSV) incompetence. This review synthesizes current evidence on clinical profile, CEAP classification, reflux anatomy, pathophysiology, and cardiometabolic burden in CVI patients undergoing EVLA.
Methods: This narrative–integrative review included recent evidence from observational studies, systematic reviews, clinical trials, and guidelines on CVI, CEAP classification, duplex ultrasound, GSV reflux, EVLA, and cardiometabolic risk.
Results: EVLA-treated CVI patients are commonly middle-aged or older, frequently female, and often have obesity, hypertension, dyslipidemia, or diabetes mellitus. Most candidates demonstrate primary, reflux-dominant superficial venous disease, especially GSV involvement, supporting EVLA as an anatomically and biologically appropriate intervention.
Discussion: Current evidence links CVI progression to aging, obesity-related venous hypertension, endothelial inflammation, and cardiometabolic dysfunction, while guidelines emphasize duplex mapping, CEAP staging, compression, and risk-factor optimization alongside ablation.1,2,3,9,11,25
Conclusion: EVLA-treated CVI represents a reflux-dominant superficial venous phenotype shaped by systemic cardiometabolic risk.