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A Journal on Phlebology
Acta Phlebologica 2008 April;9(1):33-7
Role of oral and topical phlebotrophic drugs association in CVD
Agus G. B.
Institute of Vascular Surgery and Angiology University of Milan, Milan, Italy
Phlebotrophic drugs for the chronic venous disease (CVD) are widely prescribed in Italy, France, Germany and throughout Europe, although they are less used in Anglo-Saxon and Scandinavian countries as the volume of data available in literature in these countries is less huge. Thanks to new research methodologies this trend is changing. The effects of phlebotrophic drugs on the physiological parameters, such as venous tone, venous hemodynamics, capillary permeability and lymph drainage can be evaluated with a variety of phlebology diagnostic procedures, preferably non-invasive, and in clinical, possibly double-blind, randomised trials. Several studies and consolidated clinical experiences have indicated an important therapeutic action of locally applied heparin or heparinoids in acute conditions such as superficial vein thrombosis. Only a few drugs used to treat CVD in topical forms of gel or cream have been well studied. These drugs, particularly oxerutins, have been used for more than 35 years for the treatment of CVD since they can go through the skin and reach the capillary walls, as suggested by some published studies concerning oxerutin. A recent indipendent prospective comparative trial evaluated how the efficacy of oxerutin at local level can be increased administering a topical gel in association with the systemic oral therapy. Local microcirculatory care and administration of drugs that may have a positive effect on the microcirculation have a renewed role, demonstrating that this effect is a consequence of the pharmacological action of the therapeutic gel and does not depend on massage only. This review was designed to assess the efficacy, in terms of reduction of local symptoms and signs of CVD, of the treatment with both oral and topically applied same veno-active bioflavonoids.