From Blood Clots To Healthcare Gaps, Vascular Surgeons Flag Key Concerns

Prolonged sitting while gaming, binge-watching OTT shows or working at a desk may increase the risk of blood clots, including deep vein thrombosis (DVT), vascular experts have warned, highlighting the need for greater awareness about vascular health among younger people.

The concern was raised at the three-day VSI-ASVS 2026 conference, which began in New Delhi on October 8. The meeting brought together more than 400 faculty members and over 1,000 delegates from India and abroad to discuss advances in vascular and endovascular surgery, lifestyle-related risks and gaps in access to specialised care.

DVT occurs when a blood clot forms in a deep vein, usually in the leg. If part of the clot breaks away and travels to the lungs, it can cause a potentially life-threatening pulmonary embolism.

Dr. Tapish Sahu, organising secretary of VSI-ASVS 2026 and director and head of the Department of Vascular and Endovascular Surgery at Max Hospital, New Delhi, said, “We are increasingly seeing young patients in our OPD with symptoms that make us look closely at their lifestyle, including prolonged sitting, excessive screen exposure and long gaming sessions. Earlier, it was just linked to older age or long hospitalisation.”

Citing a 2024 meta-analysis, he said the highest levels of sedentary exposure were associated with about a 24% higher risk of venous thromboembolism (VTE), while every additional hour of sedentary behaviour was associated with an approximately 2% increase in risk.

“When a young person sits continuously for four, five or six hours playing games or binge-watching OTT content, the calf muscles are barely working as a pump for venous blood. We need to make movement breaks a part of digital life.”

Dr Tarun Grover, organising chairman of VSI-ASVS 2026 and senior director of Peripheral Vascular and Endovascular Sciences at Medanta, echoed similar concerns, noting that, “In our OPD, we are seeing patients where lifestyle history has become an important part of the vascular evaluation.”

Dr Bhupesh Garg, senior vascular and endovascular surgeon and member of the Vascular Society of India, said, “Just as smoking increases vascular and clotting risks, prolonged sitting can also increase the risk of blood clots, although through a different mechanism.”

He explained that prolonged inactivity reduces the action of the calf-muscle pump, which helps return blood from the legs to the heart. When this mechanism becomes less active, blood flow can slow, increasing the risk of clot formation in susceptible individuals.

The risk is not confined to gamers. Students, office workers and people who spend long hours travelling may also remain inactive for extended periods.

Dr Ravul Jindal, Director, Vascular and Endovascular Surgery Fortis Hospital, Mohali, recommended taking regular movement breaks, walking around between gaming sessions or episodes, stretching the legs and ankles while seated, and maintaining adequate hydration. Regular physical activity is important, but breaking up long periods of sitting also matters.

Warning signs of DVT include unexplained swelling in one leg, pain or tenderness, warmth and redness. Sudden breathlessness, chest pain, coughing up blood or fainting may indicate a pulmonary embolism and require emergency medical care.

Beyond blood clots, the specialists highlighted the burden of peripheral arterial disease (PAD), particularly among people with diabetes. Reduced blood supply to the legs can cause pain, ulcers and wounds that do not heal. In severe cases, patients may require amputation.

Dr Sahu said India has over 10 crore people living with diabetes, increasing their vulnerability to arterial blockages, while nearly 5 crore are estimated to have Peripheral Arterial Disease.

“Each year, around one lakh Indians undergo limb amputation due to diabetic foot complications, but many such cases can be avoided through early detection and timely vascular care. Amputation is also associated with a significantly reduced life expectancy, often to around five years.”

The doctors stressed that family physicians, general physicians and endocrinologists can help identify warning signs and refer patients to vascular specialists before complications become severe. People with diabetes should seek medical assessment for persistent foot pain, numbness, ulcers or wounds that fail to heal.

Dr Sahu also pointed to gaps in access to specialised vascular services, noting that many hospitals, including government institutions, do not have a separate department of vascular surgery.

“Today, even at many major hospitals, there is no separate department of vascular surgery. Vascular surgery is grouped under cardiothoracic and vascular surgery, but it needs its own identity in view of the rise in such conditions,” he said.

He called for greater emphasis on vascular diseases in the MBBS curriculum so that doctors can recognise these conditions early and refer patients for appropriate treatment.

Meanwhile, technological advances are changing the management of vascular diseases. Catheter-based procedures, balloon angioplasty, stenting and specialised clot-removal devices can reduce the need for open surgery in selected patients.

Prof. V. S. Bedi, Chairman, Institute of Vascular and Endovascular Surgery, Sir Ganga Ram Hospital (SGRH), Delhi, talked about the advancements in the sector. “Treatment of blood clots has changed considerably over the past few decades, with advances in catheter-based techniques, balloon angioplasty, stenting and specialised clot-removal devices reducing the need for open surgery in selected patients.”

Earlier, around 50% of our cases may have required surgery. Today, 80% to 90% of cases can be managed through a needle puncture without open surgery, the doctor said.

Such minimally invasive procedures can shorten recovery time and help patients resume daily activities sooner. For people dependent on daily wages, an earlier return to work can also ease the financial strain on their families. However, the appropriate treatment depends on the location and severity of the clot and the patient's condition.

Dr Jindal also highlighted that vascular problems can affect children and adolescents, particularly following accidents and injuries. Delayed recognition of vascular damage after trauma can result in severe bleeding, impaired blood supply to a limb and, in some cases, amputation.

Despite improvements in treatment, access and affordability remain significant challenges. Advanced devices and procedures can be expensive, placing specialised vascular care beyond the reach of some patients.

“While technological advances are expanding treatment options, affordability remains a concern,” Dr Garg said, adding, “Advanced devices and procedures can be expensive, and many patients struggle to pay for them even when treatment is available.”

He urged the government to consider subsidies and greater financial support for vascular procedures, along with other major treatments such as cancer surgery, so that patients are not denied care because of cost.

While new technologies are widening treatment options, their benefits will remain limited unless patients can access them in time, said Dr Garg.