A Randomised Controlled Trial of Micronised Purified Flavonoid Fraction vs Placebo in Patients with Chronic Venous Disease

Abstract

in this study, MPFF did not change the symptoms of CVD, except night cramps. A secondary finding was reduced reflux times in patients with oedema, although no ultrasonographic or foot-volumetric parameters changed significantly for the whole group. The role of MPFF in treatment of patients with CVD needs to be further analysed in a large population.

Chronic Venous Disease –Management Update

“…4 Stockings in the lower pressure range (class 1, 20 to 30 mm Hg) are sufficient to control edema, but higher pressures (class 2, >30 to 40 mm Hg; or class 3, >40 mm Hg) are recommended to control venous dermatitis or ulcers. 9 In a prospective randomized double-blind controlled trial, micronised purified flavonoid fraction did not change the symptoms of CVI except for nighttime cramping 10 .Surgical therapy for CVI should be considered in patients who have failed less invasive treatments. 4 Patients with varicose veins and superficial venous reflux can undergo saphenous vein high ligation and stripping or other endovascular techniques along with branch varicosectomy to remove the offending reflux.…”

The potential use of flavonoids as venoactive drugs and the role of citrus fruits

“…Admittedly, an improvement under the influence of MPFF of venous hemodynamics assessed by strain gauge plethysmography and supramaleolar circumference in patients with CVI has been reported [25][26][27]. The data of foot volumetry have been unconvincing [9], also in the recent study [28].…”

“…In the U.S., Fl preparations are classified as dietary supplements, and in some European countries as drugs, which does not necessarily mean extensive use. So, in Scandinavia drugs are hardly ever prescribed for chronic venous disease [9]. In Spain, for certain phlebotonics the indication for CVI has been withdrawn, and for several other countriessuch as diosmine, hidrosmine, escin, and some rutosides-the use during exacerbations of CVI has been limited to two or three months [10].…”

Do We Need Evidence-Based Medicine in the Field of Venous Diseases?

“…The registry mechanism has been used to evaluate results of subfascial endoscopic perforator surgery (SEPS) in the North American registry19,20 and also to collect data on new, minimally invasive endovenous technology. 21 Large systematic reviews22 and prospective randomized trials on medical23, 24 and surgical25,26 treatment of venous disease have been done, but we need more efforts in this field. Evaluation of cutting-edge new technology in a scientific manner is always difficult, since some techniques are advertised in the public press even before reliable clinical experience with a meaningful follow-up accumulates.…”