medigraphic.com
Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2015, Number 4

<< Back Next >>

Rev Mex Angiol 2015; 43 (4)

Uso de la fracción flavonoica purificada y micronizada para el control de los síntomas después de una ablación endovenosa por radiofrecuencia

Gutiérrez-Díaz CA, Piñón-Holt D, Rojas-Gómez C, Marquina-Ramírez ME, Luna-Silva M

Language: Spanish
References: 19
Page: 138-147
PDF size: 188.59 Kb.


ABSTRACT

Introduction. The current management of the chronic venous disease requires elimination of reflux and ambulatory chronic venous hypertension. Endovenous radiofrequency ablation (ERFA) is a non invasive treatment option. The mid and long term results of ERFA suggests that it is at least as effective and durable as traditional saphenous vein surgery. Furthermore, the superiority of endovenous radiofrequency ablation over high ligation and stripping in terms of complications and return to normal physical activity has been indicated in randomized trials. ERFA operates by heating of the vein wall in its whole circumference, causing endovenous temperatures between 110-120 ºC. These energy delivery initiates an acute inflammatory response. Post-procedure symptoms are the result of the inflammation process in the vein, this can cause pain, heaviness, restless legs, swelling, induration of the treated vein and hematoma formation. The micronized purified flavonoid fraction by its unique antiinflammatory actions can be useful in diminishing post-intervention symptoms and complications.
Objective. To dermine that the micronized purified flavonoid fraction after endovenous radiofrequency ablation diminishes postoperative symptoms in patients with chronic venous disease.
Results. A total of 549 patients were studied, 275 where from the micronized purified flavonoid fraction (MPFF) group and 274 from the control group. The average age was 44.1 years old. The majority of the patients were female. The most frequently treated vein was the great saphenous vein. The MPFF group had less postoperative symptoms (pain 14.3 vs. 27.9%, heaviness 10.1 vs. 32.3%, restless legs 11.2 vs. 27.1%, swelling 16.7 vs. 30.9%, paresthesias 16.2 vs. 33.9% and hematomas 31.6 vs. 49%), better postoperative VCSS (2.4 vs. 5.1) and better quality of life CIVIQ-14 scores (p ‹ 0.05).
Conclusion. The micronized purified flavonoid fraction monotherapy reduces posoperative symptoms after endovenous radiofrequency ablation, improves VCSS and quality of life scores. The micronized purified flavonoid fraction offers a simple, single drug management to the short-term postoperative symptoms with no side effects.


REFERENCES

  1. Kaplan R, Criqui M, Denenberg J, Bergan J, Fronek A. Quality of life in patients with chronic venous disease: San Diego population study. J Vasc Surg 2003; 37: 1047-53.

  2. Rabe E, Pannier-Fischer F, Bromen K, Schuldt K, Stang A, Poncar C, et al. Bonner Venenstudie der Deutschen Gesellschaft für Phlebologie Epidemiologische Untersuchung zur Frage der Häufigkeit und Aus-prägung von chronischen Venenkrankheiten in der städtischen und ländlichen Wohnbevölkerung. Phlebologie 2003; 32: 1-14.

  3. McLafferty R, Passman M, Caprini J, Rooke T, Markwell S, Lohr J, et al. Increasing awareness about venous disease: the American Venous Forum expands the national venous screening program. J Vasc Surg 2008; 48: 394-9.

  4. Korn P, Patel S, Heller J, Deitch J, Krishnasastry K, Bush H, et al. Why insurers should reimburse for compression stockings in patients with chronic venous stasis. J Vasc Surg 2002; 35: 950-7.

  5. Caggiati A, Bergan J, Gloviczki P, Jantet G, Wendell- Smith C, Partsch H. Nomenclature of the veins of the lower limbs: An international interdisciplinary consensus statement. J Vasc Surg 2002; 36: 416-22.

  6. Meissner M, Moneta G, Burnand K, Gloviczki P, Lohr J, Lurie F, et al. The hemodynamics and diagnosis of venous disease. J Vasc Surg 2007; 46: 4-24.

  7. Raju S, Neglén P. Clinical practice. Chronic venous insufficiency and varicose veins. N Engl J Med 2009; 360: 2319-27.

  8. De Felice E. Shedding light: laser physics and mechanism of action. Phlebology 2010; 25: 11-28.

  9. Perrin M, Ramelet A. Pharmacological Treatment of Primary Chronic Venous Disease: Rationale, Results and Unanswered Questions. Eur J Vasc Endovasc Surg 2011; 41: 117-25.

  10. Konstantinos Katsenis. Micronized Purified Flavonoid Fraction (MPFF): A Review of its Pharmacological Effects, Therapeutic Efficacy and Benefits in the Management of Chronic Venous Insufficiency. Curr Vasc Pharmacol 2005; 3: 1-9.

  11. Pascarella L, Lulic I, Penn A, Alsaigh T, Lee J, Shin H, Kapur V, et al. Mechanisms in Experimental Venous Valve Failure and their Modification by Daflon 500 mg. Eur J Vasc Endovasc Surg 2008; 35: 102-10.

  12. Pokrovsky A, Savaljev V, Kirienko A, et al. Surgical correction of varicose vein disease under micronized diosmin protection (results of the Russian multicenter controlled trial DEFANS). Phlebolymphology 2008; 15: 45-51.

  13. Gloviczki P, Comerota A, Dalsing M, Eklof B, Gillespie D, Gloviczki M, Lohr J,et al. The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 2011; 53: 2-48.

  14. Lurie F, Creton D, Eklof B, Kabnick LS, Kistner RL, Pichot O, et al. Prospective randomised trial of endovenous radiofrequency obliteration (closure) versus ligation and stripping (EVOLVeS): two year follow-up. Eur J Vasc Endovasc Surg 2005; 29: 67-73.

  15. Merchant R, DePalma R, Kabnick L. Endovascular obliteration of saphenous reflux: a multicenter study. J Vasc Surg 2002; 35: 1190-6.

  16. Kabnick L, Ombrellino M, Agis H, et al. Endovenous heat induced thrombus (EHIT) following endovenous vein obliteration: To treat or not to treat? A new perioperative thrombotic classification. Presentation at the American Venous Forum 20th Annual Meeting, Charleston, SC, February 20-23, 2008.

  17. Shoab S, Porter J, Scurr J, Coleridge-Smith. Effect of oral micronized purified flavonoid fraction treatment on leukocyte adhesion molecule expression in patients with chronic venous disease: A pilot study. J Vasc Surg 2000; 31: 456-61.

  18. Vasquez M, Rabe E, McLafferty R, Shortell C, Marston W, Gillespie D, Meissner M, et al. Revision of the venous clinical severity score: Venous outcomes consensus statement: Special communication of the American Venous Forum. J Vasc Surg 2010; 52: 1387-96.

  19. Vasquez M, Munschauer C. Venous Clinical Severity Score and quality-of-life assessment tools: application to vein practice. Phlebology 2008; 23: 259-75.




2020     |     www.medigraphic.com