Adjuvant phlebotrophic therapy and its effect on anti-inflammatory response after sclerotherapy

Bogachev V.Yu.¹, Boldin B.V.¹, Lobanov V.N.², Arkadan N.R.², Ermak M.Yu.²

1) Russian National Research Medical University named after N.I. Pirogov,
2) First Phlebological Centre, Moscow, Russia

The study was aimed at evaluating the degree of the systemic and local inflammatory reaction after sclerotherapy, as well as the effect of micronized purified flavonoid fraction (Detralex) thereupon.

The study comprised a total of 60 female patients presenting with reticular veins and telangiectasias (clinical class C1 according to the CEAP classification). The patients were subdivided into two groups, each comprising 30 women. The Study Group patients two weeks prior to the forthcoming sclerotherapy had been taking Detralex prescribed at a daily dose of 1,000 mg whose administration was prolonged by not less than 2 months after the procedure. The Control Group patients received no drug. We determined the systemic and local levels of inflammatory markers, anti-inflammatory cytokines and growth factors: C-reactive protein in a highly sensitive range, histamine, interleukin-1, tumour necrosis factor alpha and vascular endothelial growth factor.

Patients in the Study and Control Groups on day 10 after sclerotherapy demonstrated a considerable increase in the levels of anti-inflammatory cytokines and inflammatory markers. At the same time, excess of the baseline levels of the parameters in patients taking Detralex was statistically significantly lower as compared with the Control Group patients: C-reactive protein – 6.0±0.9 mg/l vs 8.3±1.0 mg/l; histamine – 87.0±9.8 µg/l vs 156.9±33.9 µg/l; interleukin-1 – 5.9±0.4 pg/ml vs7.6±0.6 pg/ml; tumour necrosis factor alpha – 5.9±0.9 pg/ml vs 7.5±0.4 pg/ml; vascular endothelial growth factor – 252.3±26.0 pg/ml vs 325.1±47.7 pg/ml.

A conclusion was made that microsclerotherapy with the use of low-concentration detergent drugs was accompanied by a local vein-specific inflammatory reaction whose degree may be diminished by means of prescribing micronized purified flavonoid fraction (Detralex) two weeks prior to and during the whole subsequent period of phlebosclerosing treatment in a standard daily dose of 1,000 mg.

KEY WORDS: reticular veins, telangiectasias, sclerotherapy, inflammatory response, inflammatory markers, micronized purified flavonoid fraction, Detralex.

P. 95

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