Journal «Angiology and Vascular Surgery» • 

2016 • VOLUME 22 • №2

Transitory (evening) venous reflux in patients with intracutaneous varicosity and medicamentous correction thereof

Tsukanov Yu.T., Nikolaichuk A.I.

Chair of Surgical Diseases and Urology, Omsk State Medical University, Omsk, Russia

The authors carried out a study aimed at revealing transitory refluxes along the great saphenous vein (GSV) in patients with intracutaneous varicosity, and at investigating the possibility of removing them by means of preparations of micronized purified flavonoid fraction (MPFF).

The study included a total of one hundred and forty-seven 21-to-47-year-old (mean age 31±4.4 years) women presenting with cutaneous varicosity (class C1s). The duration of skin manifestations amounted to 9.4±3.9 years (varying from 4 to 24 years). Telangiectasias were present in 69 (46.9%) women, 36 (24.5%) women had reticular varicosity, and 42 (28.6%) a combination thereof. An author-devised test was used with prolonged orthostatic load consisting in carrying ultrasound duplex scanning twice: in the evening after 6 p. m. and in the morning before 10 a.m., assessing the evening and morning parameters of the GSV, as well as the increment of the diameter of the vein at evening measurement as compared with the morning indices.

Women with transitory refluxes along the GSV (n=59) underwent treatment with MPFF preparations (Detralex, Servier) during 60 days at a daily dose of 1,000 mg.

The morning examination showed that there was no reflux along the GSV. The evening examination revealed refluxes along the GSV of various pattern and extent in 59 (40.1 %). All the 59 patients with evening refluxes presented complaints for increased fatigability, heaviness in the lower limbs by the end of the day.

After 2 months of treatment, of the 59 women with initial reflux, 38 (64.4%) patients had no reflux and in 21 (35.6%) the extent of reflux decreased more than twofold. The evening diameter of the GSV decreased from 5.7 mm (95% CI 4.0–7.1) to 5.2 mm (95% CI 5.5–6.5) and the orthostatic gradient decreased from 0.9 mm (95% CD 0.6–1.3) to 0.6 mm (95% CI 0.4–0.8), p=0.000001. The initial complaints for heaviness in the legs after treatment disappeared in 76.6% of patients (50 of 59 subjects); in 9 women intensity of complaints decreased. The quality of life index decreased from 42 (95% CI 28–55) to 31 (95% CI 15–52) points (p=00001).

Conclusions were drawn that in intracutaneous reflux in 40.1% of cases there appear transitory evening refluxes along the GSV revealed in the day-time orthostatic test. Taking MPFFs at a dose of 1,000 mg daily during 2 months removes evening transitory reflexes in 64.4% of cases and in 35.6% of cases decrease them, thus promoting contributing to decreased intensity of venous complaints and an increase in quality of life.

KEY WORDS: telangiectasia, reticular veins, chronic venous disease, great saphenous vein, transitory reflux, micronized purified flavonoid fracture, venous reflux, quality of life.

P. 116

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