Pharmacological Correction of Venous Reflux before Surgical Treatment of Varicose Veins

Khorev N.G.; Kuznetsova D.V.

doi:https://doi.org/10.17116/flebo20231702166

N.G. Khorev

Altai State Medical University

ORCID: 0000-0002-2383-4214

D.V. Kuznetsova

Altai State Medical University

ORCID: 0000-0002-9504-4086

Pharmacological Correction of Venous Reflux before Surgical Treatment of Varicose Veins

Authors:

N.G. Khorev, D.V. Kuznetsova

More about the authors

Journal: Journal of Venous Disorders. 2023;17(2): 66‑71

DOI: 10.17116/flebo20231702166

Read: 1771 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Khorev NG, Kuznetsova DV. Pharmacological Correction of Venous Reflux before Surgical Treatment of Varicose Veins. Journal of Venous Disorders. 2023;17(2):66‑71. (In Russ.)
https://doi.org/10.17116/flebo20231702166

Подписка 2026 Флебология (Journal of Venous Disorders)

Использование инфографики авторами научных работ

Close metadata

OBJECTIVE

to assess the effectiveness of correction of venous reflux in patients with varicose veins via combination of medical treatment and surgery.

MATERIAL AND METHODS

There were 42 patients with C3-C4 varicose vein disease. All patients were prescribed with micronized purified flavonoid fraction at a daily dose of 1000 mg for one month. After that, stripping or radiofrequency ablation of great saphenous vein was performed in 19 patients. Other 23 patients were included in the control group where only venoactive drug treatment was continued. All patients underwent venous photoplethysmography before and after medical and surgical treatment. We measured venous refilling time (VRT) and ½VRT as indicators of total venous reflux.

RESULTS

Plethysmographic parameters significantly increased after administration of micronized purified flavonoid fraction in both groups. In the main group, VRT increased from 11 (9—16) to 15 (11—20) s, in the control group — from 13 (9.0—16.5) to 15.5 (11.0—19.5) s. VRT significantly increased after surgery up to 27 (15—36) s.

CONCLUSION

Micronized purified flavonoid fraction reduces total venous reflux in patients with C3—C4 varicose veins. Subsequent invasive treatment after prior drug exposure provides a significant improvement in venous return.

Keywords:

varicose veins

venous photoplethysmography

micronized purified flavonoid fraction

venous reflux

venous refilling time

Authors:

N.G. Khorev

Altai State Medical University

ORCID: 0000-0002-2383-4214

D.V. Kuznetsova

Altai State Medical University

ORCID: 0000-0002-9504-4086

Received:

27.12.2022

Accepted:

16.04.2023

Close metadata

References:

Moore HD. Deep venous valves in the aetiology of varicose veins. Lancet. 1951;2:7-10. https://doi.org/10.1016/S0140-6736(51)93450-2
Kakkos SK, Nicolaides AN. Efficacy of micronized purified flavonoid fraction (Daflon(R)) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials. Int Angiol. 2018;37:143-154.
Khorev NG, Kuznetsova DV. Pharmacological correction of total venous reflux in patients with varicose veins. Angiology and vascular surgery. 2021;27(1):84-90. (In Russ.). https://doi.org/10.33529/ANGIO2021110
Shmelev K, Gupta R. Choosing the Best Treatment Approach for Axial Vein Reflux: Thermal versus Nonthermal Approaches Semin Intervent Radiol. 2021;38(2):209-214. https://doi.org/10.1055/s-0041-1729155
Veverkova L, Jedlicka V, Wechsler J, Kalac J. Analysis of the various procedures used in great saphenous vein surgery in the Czech Republic and benefit of Daflon 500 mg to postoperative symptoms. Phlebolymphology. 2006;13:195-201. Accessed April 29, 2023. https://www.phlebolymphology.org/analysis-of-the-various-procedures-used-in-great-saphenous-vein-surgery-in-the-czech-republic-and-benefit-of-daflon-500-mg-to-postoperative-symptoms/
Saveljev VS, Pokrovsky AV, Kirienko AI, Bogachev VY, Zolotukhin IA, Sapelkin SV. Stripping of the great saphenous vein under micronized purified flavonoid fraction (MPFF) protection (results of the Russian multicenter controlled trial DEFANCE). Phlebolymphology. 2008;15(2):45-51. Accessed April 29, 2023. https://www.phlebolymphology.org/stripping-of-the-great-saphenous-vein-under-micronized-purified-flavonoid-fraction-mpff-protection-results-of-the-russian-multicenter-controlled-trial-defance/
Bogachev VY, Boldin BV, Turkin PY. Perioperative administration of micronized purified flavonoid fraction in endovascular treatment of varicose disease. Angiology and vascular surgery. 2019;25(2):88-95. (In Russ.). https://doi.org/10.33529/angio2019214
Karathanos C, Batzalexis K, Nana P, Spanos K, Kouvelos G, Rousas N, Giannoukas A. Prospective comparative study evaluating the role of flavonoids after endovenous thermal ablation. Phlebology. 2021;36(8):644-650. https://doi.org/10.1177/02683555211002331
Mansilha A, Sousa J. Benefits of venoactive drug therapy in surgical or endovenous treatment for varicose veins: a systematic review. Int Angiol. 2019;38:291-298.
Raju S, Knight A, Lamanilao L, Pace N, Jones T. Peripheral venous hypertension in chronic venous disease. J Vasc Surg Venous Lymphat Disord. 2019;7:706-714. https://doi.org/10.1016/j.jvsv.2019.03.006
Danielsson G, Jungbeck C, Peterson K, Norgren L. A Randomised Controlled Trial of Micronised Purified Flavonoid Fraction vs Placebo in Patients with Chronic Venous Disease Eur J Vasc Endovasc Surg. 2002;23:73-76. https://doi.org/10.1053/ejvs.2001.1531
Khorev NG, Kuznetsova DV, Kon’kova VO, Shoikhet YN. Plethysmography as a method for the functional evaluation of venous reflux and obstruction associated with chronic venous disease. Flebologiya. 2017;11(1):32-36. (In Russ.). https://doi.org/10.17116/flebo201711132-36
Garner RC, Garner JV, Gregory S, Whattam M, Calam A. Comparison of the absorption of micronized (DAFLON 500mg) and nonmicronized 14C-diosmin tablets after oral administration to healthy volunteers by accelerator mass spectrometry and liquid scintillation counting. Journal of Pharmaceutical Sciences. 2002;91(1):32-40. https://doi.org/10.1002/jps.1168
Onida S, Davies AH. CHIVA, ASVAL and related techniques-Concepts and evidence. Phlebology. 2015;30(2 suppl):42-45. https://doi.org/10.1177/0268355515591439
Pittaluga P, Chastanet S. Treatment of varicose veins by ASVAL: results at 10 years. Ann Vasc Surg. 2017;38:10. https://doi.org/10.1016/j.avsg.2016.07.021
Lobastov KV. Impact of Microcirculatory Disorders on the Symptoms of Chronic Venous Disease and Their Pharmacological Correction. Flebologiya. 2020;14(1):30-39. (In Russ.). https://doi.org/10.17116/flebo20201401130
Porembskaya OYa. Microcirculatory Disorders in Chronic Venous Diseases and their Systemic Pharmacological Correction. Flebologiya. 2021;15(2): 110-116. (In Russ.). https://doi.org/10.17116/flebo202115021110
Nicolaides AN, Allegra C, Bergan J, Bradbury A, Cairols M, Carpentier P, Comerota A, Delis C, Eklof B, Fassiadis N, Georgiou N, Geroulakos G, Hoffmann U, Jantet G, Jawien A, Kakkos S, Kalodiki E, Labropoulos N, Neglen P, Pappas P, Partsch H, Perrin M, Rabe E, Ramelet AA, Vayssaira M, Ioannidou E, Taft A. Management of chronic venous disorders of the lower limbs: guidelines according to scientific evidence. Int Angiol. 2008;27(1):1-59.