Abstract
The main pathogenetic mechanisms of chronic venous insufficiency are increased venous pressure and impaired venous outflow. Objective signs of the disorder include varices, oedema, skin changes and, in the most advanced stage, leg ulcer.
Subjective symptoms are represented by various complaints about discomfort in the legs, typically worsening after long standing or sitting, in hot weather or in the evening. The treatment should be complex and consists of regime measures and physiotherapy, compression therapy, surgical and endovascular methods, and pharmacotherapy.
In this indication, medicinal products from a heterogeneous group of venoactive drugs are being used. They are mainly of plant origin (flavonoids, saponins and other), some of them also semi-synthetic or synthetic (calcium dobesilate).
Venoactive drugs act by increasing venous tone, improving capillary permeability, enhancing lymphatic drainage, they exert haemorheologic and antiinflammatory effects as well. The guidelines for their use are based on the results of meta-analyses, systematic reviews and consensus statements.
Most convincing data are available for the efficacy and safety of micronized purified flavonoid fraction. In the stage of venous ulcer, sulodexid and pentoxiphyllin has proven benefit as well.
Venoactive drugs are recommended for the management of symptomatic chronic venous insufficiency in all stages. (C) 2018 Interni Medicina pro Praxi. All rights reserved.