Microcirculatory Disorders in Chronic Venous Diseases and their Systemic Pharmacological Correction

Porembskaya O.Ya.

doi:https://doi.org/10.17116/flebo202115021110

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Abstract:

This review is devoted to microcirculatory disturbances underlying chronic venous diseases (CVD) for all clinical classes. Anatomical and functional microvascular alterations represent a main mechanism of venous symptoms and disease progression. The typical signs of microvascular alterations are valvular incompetence and tortuosity that make their morphology similar to glomerular capillaries. The main parameters of skin capillary changes are increase of capillary and dermal papilla diameters, capillary bulk diameter, and decrease of capillary density. Initial capillary changes are observed even in C0S patients. Atypical microcirculatory vessels lose their ability to maintain venoarteriolar reflex and vasomotor function. Increased vascular wall permeability is followed by formation of perivascular extravasates. Inflammation and congestion reduce transcutaneous O₂ pressure and increase CO₂ pressure. These processes are accompanied by release of free radicals and triggers of tissue damage. Micronized purified flavonoid fraction (MPFF) demonstrated a significant ability to decrease venular diameter and permeability in clinical and experimental investigations. MPFF can also modify leukocyte-endothelial interactions, depress leukocyte activity with its rolling and adhesion inhibition. These mechanisms explain the high level (IA) of evidence-based effectiveness of MPFF in venous symptoms control and ulcer treatment. Considering no available data on microcirculatory disturbance reversibility, it is appropriate to consider supportive regular courses of MPFF therapy in the treatment of CVD.

Keywords:

chronic venous diseases

microcirculation

capillary bulk

capillary diameter

morphology

Authors:

Porembskaya O.Ya.

Mechnikov North-Western State Medical University;
Institute of Experimental Medicine

SPIN RSCI: 9775-1057
Scopus AuthorID: 56743328700
ORCID: 0000-0003-3537-7409

Received:

26.04.2021

Accepted:

11.05.2021

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References:

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