A New Treatment for Chronic Venous Insufficiency

The flow of blood throughout our bodies is a complicated process. In particular, the valves in our veins play a crucial role because they allow blood to flow back to the heart from other parts of the body. Sometimes, however, there are problems with those valves, including a condition called chronic venous insufficiency, or CVI, which affects one-third of adults in the United States. 

With CVI, the valves in the leg veins become damaged and don’t properly send blood back to the heart. Instead, the veins fill with blood. This is especially true when a person stands, which increases pressure in the veins, causing swelling in the legs and ankles; it can also lead to varicose veins, leg ulcers, and constant leg pain. 

While there have been surgical treatments for CVI that target superficial (or close to the skin’s surface) veins, there hasn’t been a treatment for deep valvular disease, which affects the large veins deep inside in our bodies. Now, Yale School of Medicine researchers are trying to change that.

Yale is participating in a clinical trial known as SAVVE, which stands for Surgical Antireflux Venous Valve Endoprosthesis. During this procedure, surgeons will implant a bioprosthesis—a small, metal frame that contains a porcine (i.e., from a pig) cardiac valve—into the femoral vein in the thigh. The implant stops blood from flowing back to the legs when it should only travel in one direction—toward the heart. 

“Our hope is that we can actually get the patient almost to a cure, so that they no longer have to deal with the high venous pressure you see in chronic venous insufficiency,” says Raul J. Guzman, MD, a Yale Medicine vascular and endovascular surgeon. 

In this video, Yale Medicine specialists discuss the SAVVE procedure and how it can positively impact care for patients with chronic venous insufficiency.