[Clinical and capillaroscopic evaluation of chronic uncomplicated venous insufficiency with procyanidins extracted from vitis vinifera].
BACKGROUND
The pharmacological treatment of non-complicated chronic venous insufficiency is a current and well-debated topic. The introduction of new products with action on the venous system, improved knowledge on the physiopathology of venous insufficiency and the possibility provided by new analytical instruments, have given new impulse to the consolidation of the clinical value of phlebotonics in this indication.


METHODS
In light of this, 24 patients with non-complicated chronic venous insufficiency were treated with oral administration of Oligomeric Proanthocyanidins (Pycnogenols-OPC) 100 mg/day. To evaluate the therapeutic efficacy of the treatment, an instrumental evaluation by optical probe capillaroscope was employed in addition to the traditional subjective clinical parameters: swelling, itching, heaviness and pain. The videocapillaroscope examination was performed at the lower third of the leg and the first toe. Edema in the capillaroscopic field, the number of observable capillaries and the capillary dilatation were the parameter chosen to evaluate the efficacy of treatment. All patients completed the study with no reports of adverse events during the period of observation.


RESULTS
The results obtained show a positive clinical response (improved or absent symptoms) in over 80% of patients, with significant improvement of symptoms already evident after the first 10 days of treatment. The mechanism of action of the OPCs explains the rapid reduction of the swelling of the lower limbs and correlated with this are the other evaluable symptoms: heaviness and itching. Particularly striking results were observed for itching and pain which completely disappeared during the course of therapy in 80% and 53% of the patients respectively. Noteworthy is the good correlation between the clinical and instrumental data, with improvement in a total of 70% of patients.


CONCLUSIONS
The results obtained in the course of this clinical experience, with evident improvement already during the first weeks of treatment, the absence of adverse events added to the benefit of a once-a-day administration, justify the use of OPC in the treatment of non-complicated chronic venous insufficiency.
Costantini
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A
Istituto di Chirurgia Vascolare e Angiologia, Università degli Studi, Milano.
De Bernardi
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T
Gotti
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A
D000328:Adult; D000368:Aged; D000872:Anthocyanins / Q000627:therapeutic use*; D044946:Biflavonoids; D002196:Capillaries; D002392:Catechin / Q000627:therapeutic use*; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D008875:Middle Aged; D044945:Proanthocyanidins; D014689:Venous Insufficiency / Q000175:diagnosis* / Q000188:drug therapy
D000872:Anthocyanins; D044946:Biflavonoids; D044945:Proanthocyanidins; C017674:procyanidin; D002392:Catechin