O-(beta-hydroxyethyl)-rutosides systemic and local treatment in chronic venous disease and microangiopathy: an independent prospective comparative study.
O-(beta-hydroxyethyl)-rutosides (HR) is used to treat chronic venous disease and signs and symptoms of chronic venous insufficiency (CVI), varicose veins, and deep venous disease. This independent prospective controlled trial (a registry study) evaluates how the efficacy of HR at the local level (perimalleolar region) can be increased by the administration of a topical HR gel. The study is based on evaluation of microcirculatory variables in patients with severe CVI (ambulatory venous pressure, > 56 mm Hg) and venous microangiopathy. Patients are treated using 1 of the following 3 regimens: oral treatment with 1 g sachets of HR (2 g/d total) plus topical HR 2% gel applied 3 times daily at the internal perimalleolar region; oral treatment only (same dosage), or light elastic compression stockings. Laser Doppler skin flux at rest, skin flux at the perimalleolar region, and transcutaneous PO2 and PCO2 are measured at baseline and at the end of the treatment period. A comparable group of healthy individuals without treatment is observed for 8 weeks. In the treatment groups, flux is increased, PO2 is decreased, and PCO2 is increased compared with normal skin. At 4 and 8 weeks, the improvement in skin flux (which is decreased by all measurements), the increase in PO2, and the decrease in PCO2 (indicating microcirculatory improvement) are statistically significantly greater in the combined oral plus topical treatment group (P < .05). No adverse effects, tolerability problems, or compliance issues are noted. These results indicate an important role of HR in the treatment and control of CVI and venous microangiopathy.
Belcaro
Gianni
G
Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy. Cardres@abol.it
Rosaria Cesarone
Maria
M
Ledda
Andrea
A
Cacchio
Marisa
M
Ruffini
Irma
I
Ricci
Andrea
A
Ippolito
Edmondo
E
Di Renzo
Andrea
A
Dugall
Mark
M
Corsi
Marcello
M
Marino Santarelli
Anna Rita
AR
Grossi
Maria Giovanna
MG
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D001783:Blood Flow Velocity; D001785:Blood Gas Monitoring, Transcutaneous; D002199:Capillary Permeability / Q000187:drug effects; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D003925:Diabetic Angiopathies / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004487:Edema / Q000188:drug therapy / Q000209:etiology; D005782:Gels; D006801:Humans; D006896:Hydroxyethylrutoside / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017078:Laser-Doppler Flowmetry; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012720:Severity of Illness Index; D012867:Skin / Q000098:blood supply; D053828:Stockings, Compression; D013997:Time Factors; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D014690:Venous Pressure / Q000187:drug effects
D002317:Cardiovascular Agents; D005782:Gels; D006896:Hydroxyethylrutoside; C005865:troxerutin