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Lobastov K.V.

Pirogov Russian National Research Medical University

Kaplina (Demekhova) M.Yu.

Pavlov First Saint Petersburg State Medical University

Kononova Yu.A.

Central Polyclinic No. 1 of the Ministry of Internal Affairs of Russia

Kozlova V.V.

Pirogov Russian National Research Medical University

Schastlivtsev I.V.

Pirogov Russian National Research Medical University

Phlebolymphedema: Modern Views and Methods of Correction

Authors:

Lobastov K.V., Kaplina (Demekhova) M.Yu., Kononova Yu.A., Kozlova V.V., Schastlivtsev I.V.

More about the authors

Journal: Journal of Venous Disorders. 2024;18(4): 339‑350

DOI: 10.17116/flebo202418041339

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Downloaded: 57

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Table of contents

PHLEBOLYMPHEDEMA: MODERN VIEWS AND METHODS OF CORRECTION
PHLEBOLYMPHEDEMA: MODERN VIEWS AND METHODS OF CORRECTION

To cite this article:

Lobastov KV, Kaplina (Demekhova) MYu, Kononova YuA, Kozlova VV, Schastlivtsev IV. Phlebolymphedema: Modern Views and Methods of Correction. Journal of Venous Disorders. 2024;18(4):339‑350. (In Russ.)
https://doi.org/10.17116/flebo202418041339

Подписка 2025-2 (Journal of Venous Disorders)
 
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Influence of inte­rmittent pneumatic compression on microvasculature condition in lymphedema. Prospective randomized clinical trial. Problems of Balneology, Physiotherapy and Exercise Therapy. 2024;(6):48-53

OBJECTIVE

To summarize the available data on the role of lymphatic insufficiency in CVI and its correction using CVD treatment approaches.

MATERIAL AND METHODS

We reviewed the PubMed and eLibrary databases using the keywords «phlebolymphedema», as well as analyzed available articles.

RESULTS

Revising the Starling’s law excluding fluid reabsorption at the venous end of the capillary and placing responsibility for fluid drainage on lymphatic system is important for the concept of phlebolymphedema. Progressive venous hypertension and increased plasma filtration can lead to functional insufficiency and damage to lymphatic system. Available data confirm progressive impairment of lymphatic outflow in parallel with progression of CVD. Modern methods of morphofunctional assessment of superficial lymphatic system, in particular ICG lymphography, allows us to take a new look at pathogenesis of CVI. Standard methods of CVD treatment can have a positive effect on lymphatic outflow, but available data are contradictory. Therapeutic effect of compression therapy is mainly limited to fluid movement through the interstitium towards intact lymphatic vessels. Various drugs including micronized purified flavonoid fraction demonstrate a positive effect on lymphatic drainage. Appropriate therapy is followed by effective relief of venospecific subjective symptoms, chronic edema and trophic disorders. Surgery for superficial and deep veins can improve lymphatic drainage, but clinical results are naturally worse in case of lymphatic insufficiency.

CONCLUSION

Damage to lymphatic system is essential for progressive forms of CVD that emphasizes the need for further study of this issue and development of prevention methods.

Keywords:

lymphatic system
lymphedema
phlebolymphedema
edema
Starling’s law

Authors:

Lobastov K.V.

Pirogov Russian National Research Medical University

Kaplina (Demekhova) M.Yu.

Pavlov First Saint Petersburg State Medical University

Kononova Yu.A.

Central Polyclinic No. 1 of the Ministry of Internal Affairs of Russia

Kozlova V.V.

Pirogov Russian National Research Medical University

Schastlivtsev I.V.

Pirogov Russian National Research Medical University

Received:

28.08.2024

Accepted:

05.09.2024

List of references:

  1. Pezcoller C, Saviano M, Ricchi E, Tuscano G. Use of iontophoresis in the treatment of phlebo-lymphedema. Clin Ter. 1978;86(6):561-566. 
  2. Bunke N, Brown K, Bergan J. Phlebolymphemeda: usually unrecognized, often poorly treated. Perspect Vasc Surg Endovasc Ther. 2009;21(2):65-68. 
  3. Dean SM, Valenti E, Hock K, Leffler J, Compston A, Abraham WT. The clinical characteristics of lower extremity lymphedema in 440 patients. J Vasc Surg Venous Lymphat Disord. 2020;8(5):851-859.  https://doi.org/10.1016/j.jvsv.2019.11.014
  4. Lurie F, Malgor RD, Carman T, Dean SM, Iafrati MD, Khilnani NM, Labropoulos N, Maldonado TS, Mortimer P, O’Donnell TF Jr, Raffetto JD, Rockson SG, Gasparis AP. The American Venous Forum, American Vein and Lymphatic Society and the Society for Vascular Medicine expert opinion consensus on lymphedema diagnosis and treatment. Phlebology. 2022;37(4):252-266.  https://doi.org/10.1177/02683555211053532
  5. Starling EH. On the Absorption of Fluids from the Connective Tissue Spaces. J Physiol. 1896;19(4):312-326.  https://doi.org/10.1113/jphysiol.1896.sp000596
  6. Adamson RH, Lenz JF, Zhang X, Adamson GN, Weinbaum S, Curry FE. Oncotic pressures opposing filtration across non-fenestrated rat microvessels. J Physiol. 2004;557(Pt 3):889-907.  https://doi.org/10.1113/jphysiol.2003.058255
  7. Levick JR. Revision of the Starling principle: new views of tissue fluid balance. J Physiol. 2004;557(Pt 3):704.  https://doi.org/10.1113/jphysiol.2004.066118
  8. Woodcock TE, Woodcock TM. Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy. Br J Anaesth. 2012;108(3):384-394.  https://doi.org/10.1093/bja/aer515
  9. Levick JR, Michel CC. Microvascular fluid exchange and the revised Starling principle. Cardiovasc Res. 2010;87(2):198-210.  https://doi.org/10.1093/cvr/cvq062
  10. Stucker O, Pons-Himbert C, Laemmel E. Towards a better understanding of lymph circulation. Phlebolymphology. 2008;15(1):31. 
  11. O’Morchoe CC, O’Morchoe PJ. Differences in lymphatic and blood capillary permeability: ultrastructural-functional correlations. Lymphology. 1987;20(4):205-209. 
  12. Trzewik J, Mallipattu SK, Artmann GM, Delano FA, Schmid-Schönbein GW. Evidence for a second valve system in lymphatics: endothelial microvalves. Faseb j. 2001;15(10):1711-1717. https://doi.org/10.1096/fj.01-0067com
  13. Davis MJ, Zawieja SD. Pacemaking in the lymphatic system. J Physiol. 2024. https://doi.org/10.1113/jp284752
  14. Scallan JP, Zawieja SD, Castorena-Gonzalez JA, Davis MJ. Lymphatic pumping: mechanics, mechanisms and malfunction. J Physiol. 2016;594(20): 5749-5768. https://doi.org/10.1113/jp272088
  15. Bubnova NA, Borisova RP, Kubyshkina NA. Theory of active lymph transport: morphofunctional foundations and clinical aspects. Regional blood circulation and microcirculation. 2020;19(3):80-89. (In Russ.). https://doi.org/10.24884/1682-6655-2020-19-3-80-89
  16. Zawieja DC. Contractile physiology of lymphatics. Lymphat Res Biol. 2009;7(2):87-96.  https://doi.org/10.1089/lrb.2009.0007
  17. Gianesini S, Rimondi E, Raffetto JD, Melloni E, Pellati A, Menegatti E, Avruscio GP, Bassetto F, Costa AL, Rockson S. Human collecting lymphatic glycocalyx identification by electron microscopy and immunohistochemistry. Sci Rep. 2023;13(1):3022. https://doi.org/10.1038/s41598-023-30043-x
  18. Lee BB. Phlebolymphedema: is it a new concept? Phlebolymphology. 2021; 28(1):3-13. 
  19. Junger M, Steins A, Hahn M, Hafner HM. Microcirculatory dysfunction in chronic venous insufficiency (CVI). Microcirculation. 2000;7(6 Pt 2):3-12. 
  20. Franzeck UK, Haselbach P, Speiser D, Bollinger A. Microangiopathy of cutaneous blood and lymphatic capillaries in chronic venous insufficiency (CVI). Yale J Biol Med. 1993;66(1):37-46. 
  21. Virgini-Magalhaes CE, Porto CL, Fernandes FF, Dorigo DM, Bottino DA, Bouskela E. Use of microcirculatory parameters to evaluate chronic venous insufficiency. J Vasc Surg. 2006;43(5):1037-1044. https://doi.org/10.1016/j.jvs.2005.12.065
  22. Ulloa H, Cifuentes S, Figueroa V, Uden V, Bravo J, Amore M, Ramirez J. Phlebolymphedema: an up to date review. Phlebolymphology. 2021;104(28):2. 
  23. Vorontsova AV, Lobastov KV, Laberko LA, Barinov VE. On the pathogenesis of varicose veins. Khirurg. 2018;(7-8):58-74. (In Russ.).
  24. Castro-Ferreira R, Cardoso R, Leite-Moreira A, Mansilha A. The Role of Endothelial Dysfunction and Inflammation in Chronic Venous Disease. Ann Vasc Surg. 2018;46:380-393.  https://doi.org/10.1016/j.avsg.2017.06.131
  25. Bowman C, Rockson SG. The Role of Inflammation in Lymphedema: A Narrative Review of Pathogenesis and Opportunities for Therapeutic Intervention. Int J Mol Sci. 2024;25(7):3907. https://doi.org/10.3390/ijms25073907
  26. Bollinger A, Isenring G, Franzeck UK. Lymphatic microangiopathy: a complication of severe chronic venous incompetence (CVI). Lymphology. 1982;15(2):60-65. 
  27. Bollinger A, Pfister G, Hoffmann U, Franzeck UK. Fluorescence microlymphography in chronic venous incompetence. Int Angiol. 1989;8(4 Suppl):23-26. 
  28. Scelsi R, Scelsi L, Cortinovis R, Poggi P. Morphological changes of dermal blood and lymphatic vessels in chronic venous insufficiency of the leg. Int Angiol. 1994;13(4):308-311. 
  29. Eliska O, Eliskova M. Morphology of lymphatics in human venous crural ulcers with lipodermatosclerosis. Lymphology. 2001;34(3):111-123. 
  30. Cariati A. Investigation of the leg lymphatic function in patients with leg acute venous thrombosis and in patients with leg post-thrombotic syndrome. The Open Circulation & Vascular Journal. 2010;3(1):67-71.  https://doi.org/10.2174/1877382601003010067
  31. Dzhumabaev ES, Dzhumabaeva SE. Lymphatic Outflow and Correction of Appropriate Disorders in Patients with Venous Thrombosis and Chronic Venous Disease. Journal of Venous Disorders. 2024;18(1):26-31. (In Russ.). https://doi.org/10.17116/flebo20241801126
  32. Partsch H, Stöberl C, Urbanek A, Wenzel-Hora BI. Clinical use of indirect lymphography in different forms of leg edema. Lymphology. 1988;21(3):152-160. 
  33. Raju S, Furrh JBt, Neglén P. Diagnosis and treatment of venous lymphedema. J Vasc Surg. 2012;55(1):141-149.  https://doi.org/10.1016/j.jvs.2011.07.078
  34. Gombert A, Heinzel A, Barbati ME, Doukas P, Schmitt L, Shekarchian S, Winz O, Mottaghy F, Jalaie H. Assessment of the lymphatic system by indirect lymphography in patients with post-thrombotic syndrome. J Vasc Surg Venous Lymphat Disord. 2022;10(5):1072-1078. https://doi.org/10.1016/j.jvsv.2022.03.014
  35. Sevick-Muraca EM, Fife CE, Rasmussen JC. Imaging peripheral lymphatic dysfunction in chronic conditions. Front Physiol. 2023;14:1132097. https://doi.org/10.3389/fphys.2023.1132097
  36. Suami H, Thompson B, Mackie H, Blackwell R, Heydon-White A, Blake FT, Boyages J, Koelmeyer L. A new indocyanine green fluorescence lymphography protocol for diagnostic assessment of lower limb lymphoedema. J Plast Reconstr Aesthet Surg. 2022;75(11):3946-3955. https://doi.org/10.1016/j.bjps.2022.08.017
  37. Rasmussen JC, Zhu B, Morrow JR, Aldrich MB, Sahihi A, Harlin SA, Fife CE, O’Donnell TF Jr, Sevick-Muraca EM. Degradation of lymphatic anatomy and function in early venous insufficiency. J Vasc Surg Venous Lymphat Disord. 2021;9(3):720-730.  https://doi.org/10.1016/j.jvsv.2020.09.007
  38. Rasmussen JC, Aldrich MB, Tan IC, Darne C, Zhu B, O’Donnell TF Jr, Fife CE, Sevick-Muraca EM. Lymphatic transport in patients with chronic venous insufficiency and venous leg ulcers following sequential pneumatic compression. J Vasc Surg Venous Lymphat Disord. 2016;4(1):9-17.  https://doi.org/10.1016/j.jvsv.2015.06.001
  39. Miseré RML, Wolfs J, Lobbes MBI, van der Hulst R, Qiu SS. A systematic review of magnetic resonance lymphography for the evaluation of peripheral lymphedema. J Vasc Surg Venous Lymphat Disord. 2020;8(5):882-892.  https://doi.org/10.1016/j.jvsv.2020.03.007
  40. Kamaev AA, Bulatov VL, Vakhrat’yan PE, Volkov AM, Volkov AS, Gavrilov EK, Golovina VI, Efremova OI, Ivanov OO, Ilyukhin EA, Katorkin SE, Konchugova TV, Kravtsov PF, Maksimov SV, Mzhavanadze ND, Pikhanova ZhM, Pryadko SI, Smirnov AA, Sushkov SA, Chabbarov RG, Shimanko AI, Yakushkin SN, Apkhanova TV, Derkachev SN, Zolotukhin IA, Kalinin RE, Kirienko AI, Kul’chitskaya DB, Pelevin AV, Petrikov AS, Rachin AP, Seliverstov EI, Stoiko YuM, Suchkov IA. Varicose Veins. Journal of Venous Disorders. 2022;16(1):41-108. (In Russ.). https://doi.org/10.17116/flebo20221601141
  41. Lobastov KV, Bondarchuk DV, Borsuk DA, Bredikhin RA, Bukina OV, Pankov AS, Porembskaya OYa, Son’kin IN, Schastlivtsev IV, Tauraginskii RA. Diagnosis and treatment of chronic venous obstruction: consensus statement of the Russian experts (Part 1). Khirurg. 2020;5(6):5-37. (In Russ.). https://doi.org/10.33920/med-15-2003-01
  42. Lobastov KV, Bondarchuk DV, Borsuk DA, Bredikhin RA, Bukina OV, Pankov AS, Porembskaya OYa, Son’kin IN, Schastlivtsev IV, Tauraginskii RA. Diagnosis and treatment of chronic venous obstruction: consensus statement of the Russian experts (Part 2). Khirurg. 2020;7(8):22-55. (In Russ.). https://doi.org/10.33920/med-15-2004-02
  43. Partsch H, Flour M, Smith PC. International Compression, C., Indications for compression therapy in venous and lymphatic disease consensus based on experimental data and scientific evidence. Under the auspices of the IUP. Int Angiol. 2008;27(3):193-219. 
  44. Rabe E, Partsch H, Hafner J, Lattimer C, Mosti G, Neumann M, Urbanek T, Huebner M, Gaillard S, Carpentier P. Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement. Phlebology. 2018;33(3):163-184.  https://doi.org/10.1177/0268355516689631
  45. Bjork R, Ehmann S. S.T.R.I.D.E. Professional Guide to Compression Garment Selection for the Lower Extremity. J Wound Care. 2019; 28(Sup6a):1-44.  https://doi.org/10.12968/jowc.2019.28.Sup6a.S1
  46. Franzeck UK, Spiegel I, Fischer M, Börtzler C, Stahel HU, Bollinger A. Combined physical therapy for lymphedema evaluated by fluorescence microlymphography and lymph capillary pressure measurements. J Vasc Res. 1997;34(4):306-311.  https://doi.org/10.1159/000159238
  47. Miranda F Jr, Perez MC, Castiglioni ML, Juliano Y, Amorim JE, Nakano LC, de Barros N Jr, Lustre WG, Burihan E. Effect of sequential intermittent pneumatic compression on both leg lymphedema volume and on lymph transport as semi-quantitatively evaluated by lymphoscintigraphy. Lymphology. 2001;34(3):135-141. 
  48. Olszewski WL, Cwikla J, Zaleska M, Domaszewska-Szostek A, Gradalski T, Szopinska S. Pathways of lymph and tissue fluid flow during intermittent pneumatic massage of lower limbs with obstructive lymphedema. Lymphology. 2011;44(2):54-64. 
  49. Zaleska MT, Olszewski WL. The Effectiveness of Intermittent Pneumatic Compression in Therapy of Lymphedema of Lower Limbs: Methods of Evaluation and Results. Lymphat Res Biol. 2019;17(1):60-69.  https://doi.org/10.1089/lrb.2018.0005
  50. Zaleska M, Olszewski WL, Cakala M, Cwikla J, Budlewski T. Intermittent Pneumatic Compression Enhances Formation of Edema Tissue Fluid Channels in Lymphedema of Lower Limbs. Lymphat Res Biol. 2015;13(2):146-153.  https://doi.org/10.1089/lrb.2014.0010
  51. Kitayama S, Maegawa J, Matsubara S, Kobayashi S, Mikami T, Hirotomi K, Kagimoto S. Real-Time Direct Evidence of the Superficial Lymphatic Drainage Effect of Intermittent Pneumatic Compression Treatment for Lower Limb Lymphedema. Lymphat Res Biol. 2017;15(1):77-86.  https://doi.org/10.1089/lrb.2016.0031
  52. Nicolaides A, Kakkos S, Baekgaard N, Comerota A, de Maeseneer M, Eklof B, Giannoukas AD, Lugli M, Maleti O, Myers K, Nelzen O, Partsch H, Perrin M. Management of chronic venous disorders of the lower limbs. Guidelines According to Scientific Evidence. Part I. Int Angiol. 2018;37(3):181-254.  https://doi.org/10.23736/S0392-9590.18.03999-8
  53. De Maeseneer MG, Kakkos SK, Aherne T, Baekgaard N, Black S, Blomgren L, Giannoukas A, Gohel M, de Graaf R, Hamel-Desnos C, Jawien A, Jaworucka-Kaczorowska A, Lattimer CR, Mosti G, Noppeney T, van Rijn MJ, Stansby G, Esvs Guidelines C, Kolh P, Bastos Goncalves F, Chakfe N, Coscas R, de Borst GJ, Dias NV, Hinchliffe RJ, Koncar IB, Lindholt JS, Trimarchi S, Tulamo R, Twine CP, Vermassen F, Wanhainen A, Document R, Bjorck M, Labropoulos N, Lurie F, Mansilha A, Nyamekye IK, Ramirez Ortega M, Ulloa JH, Urbanek T, van Rij AM, Vuylsteke ME. Editor’s Choice — European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63(2):184-267.  https://doi.org/10.1016/j.ejvs.2021.12.024
  54. Gloviczki P, Lawrence PF, Wasan SM, Meissner MH, Almeida J, Brown KR, Bush RL, Di Iorio M, Fish J, Fukaya E, Gloviczki ML, Hingorani A, Jayaraj A, Kolluri R, Murad MH, Obi AT, Ozsvath KJ, Singh MJ, Vayuvegula S, Welch HJ. The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II: Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine. J Vasc Surg Venous Lymphat Disord. 2024;12(1):101670. https://doi.org/10.1016/j.jvsv.2023.08.011
  55. Mansilha A, Gianesini S, Ulloa JH, Lobastov K, Wang J, Freitag A, Schaible KR, Martin M, Yaltirik P, Nicolaides AN. Pharmacological treatment for chronic venous disease: an umbrella review of systematic reviews. Int Angiol. 2022;41(3):249-257.  https://doi.org/10.23736/s0392-9590.22.04877-5
  56. Talibov OB. Diosmin in the treatment of venous disease: pharmacokinetics and pharmacodynamics. Pirogov Russian Journal of Surgery. 2019;3: 135-140. (In Russ.). https://doi.org/10.17116/hirurgia2019031135
  57. Labrid C. A lymphatic function of Daflon 500 mg. Int Angiol. 1995;14 (3 Suppl 1):36-38. 
  58. Cotonat A, Cotonat J. Lymphagogue and pulsatile activities of Daflon 500 mg on canine thoracic lymph duct. Int Angiol. 1989;8(4 Suppl):15-18. 
  59. Shishlo VK, Malinin AA, Dyurzhanov AA. Mechanisms of antioedemic effect of bioflavonoids in experiment. Angiologiya i sosudistaya khirurgiya. 2013;19(2):25-33. (In Russ.).
  60. Allegra C, Bartolo M, Carioti B, Cassiani D, Besse Boffi M. Microlymphography: assessment of Daflon 500 mg activity in patients with chronic venous insufficiency. Lymphology. 1998;31:12-16. 
  61. Bouskela E, Donyo KA. Effects of oral administration of purified micronized flavonoid fraction on increased microvascular permeability induced by various agents and on ischemia/reperfusion in the hamster cheek pouch. Angiology. 1997;48(5):391-399.  https://doi.org/10.1177/000331979704800503
  62. Paysant J, Sansilvestri-Morel P, Bouskela E, Verbeuren TJ. Different flavonoids present in the micronized purified flavonoid fraction (Daflon 500 mg) contribute to its anti-hyperpermeability effect in the hamster cheek pouch microcirculation. Int Angiol. 2008;27(1):81-85. 
  63. Buzlama AV, Verlina AA, Kuznetsov AYu, Aleksenko EA. Comparative evaluation of effect of phlebotropic agents on vascular wall permeability in preclinical studies. Ambulatornaya khirurgiya. 2023;20(2):150-158. (In Russ.). https://doi.org/10.21518/akh2023-042
  64. Takase S, Lerond L, Bergan JJ, Schmid-Schonbein GW. The inflammatory reaction during venous hypertension in the rat. Microcirculation. 2000;7(1):41-52. 
  65. Takase S, Pascarella L, Lerond L, Bergan JJ, Schmid-Schonbein GW. Venous hypertension, inflammation and valve remodeling. Eur J Vasc Endovasc Surg. 2004;28(5):484-493.  https://doi.org/10.1016/j.ejvs.2004.05.012
  66. Pascarella L, Lulic D, Penn AH, Alsaigh T, Lee J, Shin H, Kapur V, Bergan JJ, Schmid-Schonbein GW. Mechanisms in experimental venous valve failure and their modification by Daflon 500 mg. Eur J Vasc Endovasc Surg. 2008;35(1):102-110.  https://doi.org/10.1016/j.ejvs.2007.08.011
  67. das Gracas CdSM, Cyrino FZ, de Carvalho JJ, Blanc-Guillemaud V, Bouskela E. Protective Effects of Micronized Purified Flavonoid Fraction (MPFF) on a Novel Experimental Model of Chronic Venous Hypertension. Eur J Vasc Endovasc Surg. 2018;55(5):694-702.  https://doi.org/10.1016/j.ejvs.2018.02.009
  68. Cyrino FZ, Blanc-Guillemaud V, Bouskela E. Time course of microvalve pathophysiology in high pressure low flow model of venous insufficiency and the role of micronized purified flavonoid fraction. Int Angiol. 2021;40(5):388-394.  https://doi.org/10.23736/s0392-9590.21.04726-x
  69. 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(2):143-154.  https://doi.org/10.23736/S0392-9590.18.03975-5
  70. Planchon B. Venous insufficiency and Daflon 500 mg. Artères Veines. 1990;9:376-380. 
  71. Frileux C, Gilly R. Activité thérapeutique de Daflon 500 mg dans l’insuffisance veineuse chronique des membres inférieurs. J Int Méd. 1987;99:36-39. 
  72. Coleridge-Smith P, Lok C, Ramelet AA. Venous leg ulcer: a meta-analysis of adjunctive therapy with micronized purified flavonoid fraction. Eur J Vasc Endovasc Surg. 2005;30(2):198-208.  https://doi.org/10.1016/j.ejvs.2005.04.017
  73. Guillot B, Guilhou JJ, de Champvallins M, Mallet C, Moccatti D, Pointel JP. A long term treatment with a venotropic drug. Results on efficacy and safety of Daflon 500 mg in chronic venous insufficiency. Int Angiol. 1989;8(4 Suppl):67-71. 
  74. Lobastov K, Schastlivtsev I, Barinov V. Micronized purified flavonoid fraction in adjunction to rivaroxaban improves outcomes of popliteal-femoral deep-vein thrombosis at 12-month follow-up. Phlebolymphology. 2020;27(3):113-124. 
  75. Bogachev VYu, Boldin BV, Turkin PYu, Dzhenina OV, Samenkov AYu. Current indications for phlebotropic therapy and its duration. Ambulatornaya khirurgiya. 2021;1:13-23. (In Russ.). https://doi.org/10.21518/1995-1477-2021-18-1-13-23
  76. Pecking AP. Evaluation by lymphoscintigraphy of the effect of a micronized flavonoid fraction (Daflon 500 mg) in the treatment of upper limb lymphedema. Int Angiol. 1995;14(3 Suppl 1):39-43. 
  77. Pecking AP, Février B, Wargon C, Pillion G. Efficacy of Daflon 500 mg in the treatment of lymphedema (secondary to conventional therapy of breast cancer). Angiology. 1997;48(1):93-98.  https://doi.org/10.1177/000331979704800115
  78. Michaels JA, Brazier JE, Campbell WB, MacIntyre JB, Palfreyman SJ, Ratcliffe J. Randomized clinical trial comparing surgery with conservative treatment for uncomplicated varicose veins. Br J Surg. 2006;93(2):175-181.  https://doi.org/10.1002/bjs.5264
  79. Rossi FH, Kambara AM, Izukawa NM, Rodrigues TO, Rossi CB, Sousa AG, Metzger PB, Thorpe PE. Randomized double-blinded study comparing medical treatment versus iliac vein stenting in chronic venous disease. J Vasc Surg Venous Lymphat Disord. 2018;6(2):183-191.  https://doi.org/10.1016/j.jvsv.2017.11.003
  80. Shekarchian S, Van Laanen J, Esmaeil Barbati M, Vleugels MJ, Nelemans P, Razavi MK, Mees B, Jacobs MJ, Jalaie H. Editor’s Choice — Quality of Life after Stenting for Iliofemoral Venous Obstruction: A Randomised Controlled Trial with One Year Follow Up. Eur J Vasc Endovasc Surg. 2023;66(5):678-685.  https://doi.org/10.1016/j.ejvs.2023.07.044
  81. Özkan U, Saritüürk Ç. Early clinical improvement in chronic venous insufficiency symptoms after laser ablation of saphenous veins. Diagn Interv Radiol. 2012;18(6):594-598.  https://doi.org/10.4261/1305-3825.Dir.5917-12.1
  82. Klitfod L, Sillesen H, Jensen LP. Patients and physicians agree only partially in symptoms and clinical findings before and after treatment for varicose veins. Phlebology. 2018;33(2):115-121.  https://doi.org/10.1177/0268355516686444
  83. Shutze W, Shutze R, Dhot P, Ogola GO. Patient-reported outcomes of endovenous superficial venous ablation for lower extremity swelling. Phlebology. 2019;34(6):391-398.  https://doi.org/10.1177/0268355518814130
  84. Mauck KF, Asi N, Undavalli C, Elraiyah TA, Nabhan M, Altayar O, Sonbol MB, Prokop LJ, Murad MH. Systematic review and meta-analysis of surgical interventions versus conservative therapy for venous ulcers. J Vasc Surg. 2014;60(2 Suppl):60S-70S.  https://doi.org/10.1016/j.jvs.2014.04.059
  85. Cai PL, Hitchman LH, Mohamed AH, Smith GE, Chetter I, Carradice D. Endovenous ablation for venous leg ulcers. Cochrane Database Syst Rev. 2023;7(7):Cd009494. https://doi.org/10.1002/14651858.CD009494.pub3
  86. Suzuki M, Unno N, Yamamoto N, Nishiyama M, Sagara D, Tanaka H, Mano Y, Konno H. Impaired lymphatic function recovered after great saphenous vein stripping in patients with varicose vein: venodynamic and lymphodynamic results. J Vasc Surg. 2009;50(5):1085-1091. https://doi.org/10.1016/j.jvs.2009.06.003
  87. Dessalvi S, Villa G, Campisi CC, Campisi C, Boccardo F. Decreasing and preventing lymphatic-injury-related complications in patients undergoing venous surgery: A new diagnostic and therapeutic protocol. Lymphology. 2018;51(2):57-65. 
  88. Jayaraj A, Thaggard D. The beneficial role of complex decongestive therapy in patients with symptomatic chronic iliofemoral venous obstruction with phlebolymphedema. J Vasc Surg Venous Lymphat Disord. 2024;12(1):101686. https://doi.org/10.1016/j.jvsv.2023.08.024
  89. Genet M, Labropoulos N, Gasparis A, O’Donnell T, Desai K. The clinical and economic impact of chronic venous insufficiency-associated lymphedema and the prevalence of persistent edema after venous intervention. Phlebology. 2024;39(5):353-358.  https://doi.org/10.1177/02683555241233355

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