Search

Objectives: A variety of studies have suggested that flavonoids are effective for the treatment of CVD. However, many questions remain about their mechanism of action and when, how, and for what signs and symptoms they should be used. Method: A panel of experts in CVD met in Budapest, Hungary in December 2011 to discuss the current state of knowledge of CVD and the role of flavonoids in its treatment. The discussion was based on a literature search in the current databases. The goals of this paper are recommendations for further studies on the use of flavonoids in the treatment of CVD. Results: There is good evidence to recommend the use of flavonoids in the treatment of CVD. However, because of the poor quality of some older clinical trials, inadequate reporting, and insufficient information, much work is still needed to firmly establish their clinical efficacy and to determine when and how they should be employed. In particular, long-term randomized, placebo-controlled, double-blind studies are needed to establish the efficacy and safety of flavonoids. Additional studies are also needed to establish their mechanism of action, pharmacokinetics, toxicity, and cost-effectiveness. Conclusions: Aside from good evidence for the use of flavonoids in CVD further studies are indicated to establish long term treatment in this indication. [ABSTRACT FROM AUTHOR]

Objective: To test the efficacy of calcium dobesilate (CaD) in chronic venous insufficiency (CVI). Method: Double-blind, parallel groups, placebo-controlled, multicentre trial in adult patients with symptomatic CVI and pitting oedema. Wearing of compression stockings Class II was admitted. During treatment period of eight weeks, the patients received CaD 3 x 500 mg/day or placebo. The leg volume calculation was based on a truncated cone model. Results: A total of 256 patients was randomized to treatment (dobesilate: n = 132, placebo: n = 124); the demographic and anamnestic data at admission were comparable in the two therapeutic groups. The volume of the lower calf diminished in the dobesilate group at the end of the active treatment period by -64.72 ± 111.93 cm³ (mean ± SD), independent of the concomitant usage of compression stockings versus placebo +0.8 ± 152.98 cm³ (P = 0.0002). The symptoms of pain, discomfort, heavy legs, tired legs, tingling, itching and cramps, as well as the global assessments by investigators and patients, also improved significantly (P < 0.05) better in the dobesilate group at the end of the treatment. The observed adverse events correspond to the known profile. Conclusion: Dobesilate reduces leg oedema and improves the symptoms of objectively diagnosed CVI, independent of the concomitant usage of compression stockings. [ABSTRACT FROM AUTHOR]

The article presents an overview of the socioeconomic costs of chronic venous insufficiency, which is due to the large number of patients with the condition, the cost of investigations and management of the condition and the deterioration of the quality of life and loss of working days in patients with the condition. A discussion of the costs that are associated with advanced stages of the condition, and of the prevalence of venous treatment in the general population, is presented.

The article presents a study that assessed the effect of immediately performing embolization in the treatment of leg varices associated with pelvic venous insufficiency (PVI). The results indicate show that embolization is not essential in treating leg varicose veins of pelvic origin. Foam sclerotherapy or phlebectomy is effective for patients with vulvar or pudendal varicose veins.

The article presents a review of epidemiologic studies concerning the progression of venous pathology in varicose veins and from varicose veins towards chronic venous insufficiency. Data from Medline and PubMed indicate that reflux progression may develop from segmental to multisegmental superficial reflux. Risk factors for the progression of varicose veins towards venous leg ulcers include skin changes, corona phlebectatica and popliteal vein reflux.

The authors reflect on the future of phlebology in Europe. They suggest that a European College of Phlebology (ECoP) has been established to provide optimal care for all patients in Europe suffering from a venous disease. They argue that all medical personnel and patients in Europe should collaborate with the ECoP to help guide the quality of care provided to patients with venous disease.