Pharmacological correction of total venous reflux in patients with varicose veins

Nikolai KHOREV,1 MD, PhD; Darya KUZNETSOVA,2 MD, PhD 1Department of Cardiology and Cardiovascular Surgery, Altai State Medical University, Barnaul, Russia 2Department of Pathological Anatomy, Department of Pathophysiology Altai State Medical University, Barnaul, Russia Abstract The study was aimed at evaluating the efficacy of micronized purified flavonoid fraction (MPFF) in patients with primary chronic venous disease (CVD). It included 35 patients with varicose veins of the lower extremities (18 with bilateral and 7 with unilateral lesion). A total of 53 legs with varicose veins were evaluated in 3 groups based on the CEAP (Clinical, Etiology, Anatomic, Pathophysiology classification system) clinical class:…

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The new patient-oriented tools for clinical assessment of pelvic varicose disease

Rustem VILEVICH AKHMETZIANOV, MD, PhD Doctor of Medical Sciences, Cardiovascular Surgeon of the Department of Vascular Surgery, Inter-regional Clinical Diagnostic Center of the Ministry of Health of Russia, Assistant of the Department of Cardiovascular and Endovascular Surgery, Kazan State Medical University of the Ministry of Health of Russia, Kazan, Russia Abstract This article presents a review of patient-oriented diagnostic tools currently used in patients with pelvic varicose veins (pelvic congestion syndrome, PCS), and provides rationale for using disease-specific tools, as highlighted in the international consensus documents on the diagnosis and treatment of PCS. The authors present two original diagnostic tools…

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The place of micronized purified flavonoid fraction in the management of chronic venous disease from an international guidelines’ perspective

Sergey Gennadievich GAVRILOV, MD, PhD Jorge H. ULLOA, MD1; Sebastian CIFUENTES, MD2; Antonio SOLANO, MD2; Valentin FIGUEROA, MD2 1Vascular Surgeon, Chief of Vascular Surgery Department, Fundación Santa Fe de Bogotá University Hospital; Professor of Surgery, Universidad de los Andes School of Medicine, Bogotá, Colombia. 2Vascular Surgery Research Fellow, Vascular Surgery Department, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia. Abstract Chronic venous disease (CVD) is a highly prevalent disorder with a broad spectrum of symptoms determined by disease stage and whether there is deep or superficial venous system compromise. The treatment goal for CVD is to slow and prevent…

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Microcirculatory disorders in chronic venous diseases and fundamentals of their systemic pharmacological correction

Olga Ya POREMBSKAYA, MD, PhD Mechnikov North-Western State Medical University, Saint Petersburg, Russia and Institute of Experimental Medicine, Saint Petersburg, Russia Abstract This article reviews the literature on microcirculatory disorders underlying the development of chronic venous diseases (CVD) across all the CEAP (Clinical-Etiology- Anatomy-Pathophysiology) clinical classes from C0s to C6 and the fundamentals of their systemic pharmacological correction particularly with micronized purified flavonoid fraction (MPFF). Anatomical and functional changes specifically in the vessels of the microvasculature are the main pathogenetic mechanism for the development of most vein-specific symptoms and determine CVD progression. The altered vessels of the microvasculature are characterized…

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Phlebolymphedema: an up-to-date review

Jorge H. ULLOA,1 MD, FACS; Sebastian CIFUENTES,2 MD; Valentin FIGUEROA,2 MD; Emelyn Van UDEN,2 MD; Javier A. BRAVO,2 MD; Miguel AMORE,3 MD; Jairo RAMÍREZ,1 MD, FACS 1Vascular Surgery Department, Fundación Santa Fe de Bogotá University Hospital; Universidad de los Andes Medical School. Bogotá, Colombia; 2Universidad de los Andes Medical School, Fundación Santa Fe de Bogotá University Hospital. Bogotá, Colombia; 3Vascular Surgery Department, Fundación Favaloro, Buenos Aires, Argentina Abstract Phlebolymphedema is a vascular condition in which there is damage of the venous and lymphatic systems in the lower limbs. It is secondary to chronic venous insufficiency, which results in venous hypertension…

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Course duration for venoactive-drug treatment in chronic venous disease

Roman KALININ, MD, PhD, DMedSc; Igor SUCHKOV, MD, PhD, DMedSc; Aleksey KAMAEV, MD, PhD; Nina MZHAVANADZE, MD, PhD. MD Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University, Ryazan, Russia Abstract Chronic venous disease (CVD) is currently the most common vascular disorder of the lower extremities. The gradual progression of CVD has a negative impact on patients and also leads to high economic costs of medical care, especially for the advanced forms of chronic venous insufficiency (CVI). Conservative management of CVD includes the use of compression stockings and pharmacological therapy. Despite the efficacy of compression therapy,…

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Micronized purified flavonoid fraction in adjunction to rivaroxaban improves outcomes of popliteal-femoral deep-vein thrombosis at 12-month follow-up

Kirill LOBASTOV,1 MD, PhD; Ilya SCHASTLIVTSEV,1,2 MD, PhD; Victor BARINOV,2 MD, PhD 1Pirogov Russian National Research Medical University, Moscow, Russian Federation; 2Clinical Hospital no.1 of the President’s Administration of the Russian Federation Abstract Aim: To assess the efficacy of the long-term use of micronized purified flavonoid fraction (MPFF) in the treatment of popliteal-femoral deep-vein thrombosis (DVT). Methods: In this pilot, comparative, open-label clinical study, patients with the first episode of popliteal-femoral DVT confirmed by duplex ultrasound scan (DUS) were allocated to two groups: the control group received standard treatment with rivaroxaban for 6 months and compression stockings for 12 months,…

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Effectiveness of micronized purified flavonoid fraction–based conservative treatment in chronic venous edema

Vadim Yu BOGACHEV, MD, PhD On behalf of the VAP-PRO-C3 study investigators group. Department of Faculty Surgery No. 2, Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia Abstract Aim: This study assessed the effectiveness of micronized purified flavonoid fraction (MPFF)-based conservative treatment in patients with chronic venous edema (CVE) as part of an observational program that evaluated the management of patients with CVE caused by the primary forms of chronic venous disease (CVD) in real clinical practice. Materials and methods. The VAP-C3 (Vein Act Prolonged-C3; NCT03722836) prospective, single-arm, observational study was conducted in Russia in adult outpatients with CVD…

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Diagnosis and treatment of situational great saphenous vein reflux in daily medical practice

Yu. T. TSUKANOV, A. Yu. TSUKANOV, Department of Surgery and Urology, Omsk State Medical University, Omsk, Russia Abstract Aim: To analyze the treatments for situational great saphenous vein (GSV) reflux. Methods: Patients with chronic venous disease who were classified as C0s, C0,1s, and C2 (n=294) were analyzed using a day orthostatic load (DOL) test. Situational GSV reflux occurred in 78 patients. The patients classified as C0s and C0,1s (group 1; n=46) and the patients with reflux still present after surgery on varicose tributaries (group 3; n=10) received micronized purified flavonoid fraction (MPFF) 1000 mg daily for 90 days. Patients classified…

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Medical treatment of pelvic congestion syndrome

Omur TASKIN1; Levent SAHIN2; Sergey G. GAVRILOV3; Zaza LAZARASHVILI4 1 Akdeniz School of Medicine, Department of Obstetrics and Gynaecology, Antalya, Turkey 2 Kafkas School of Medicine, Departme of Obstetrics and Gynaecology, Kars, Turkey 3 Leninskii Prospekt, Moscow, Russia 4 Chapidze Emergency Cardiovascular Center, Tbilisi, Georgia Abstract Pelvic congestion syndrome (PCS) has no clear etiology and the diagnosis relies on precise investigation techniques. PCS patients present with chronic symptoms in the area of the pelvis, which may have various etiologies; therefore, before any treatment is administered, it is important to exclude other medical conditions that may cause similar symptoms. Treatment options…

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