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O-(β-Hydroxyethyl)-Rutosides Systemic and Local Treatment in Chronic Venous Disease and Microangiopathy: An Independent Prospective Comparative Study

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy, Cardres{at}abol.it

Maria Rosaria Cesarone, MD

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

Andrea Ledda, MD

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

Marisa Cacchio, MD

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

Irma Ruffini, MD

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

Andrea Ricci, MD

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

Edmondo Ippolito, MD

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

Andrea Di Renzo

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

Mark Dugall

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

Marcello Corsi, MD

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

Anna Rita Marino Santarelli, MD

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

Maria Giovanna Grossi

Department of Biomedical Sciences, Chieti-Pescara University, and the San Valentino Vascular Screening Project, Italy

O-(β-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 PO ₂, 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.

Key Words: venous disease • varicose veins • ulcerations • HR • O-(β-hydroxyethyl)-rutosides • elastic compression • edema • veins • venous microangiopathy

Angiology, Vol. 59, No. 1 suppl, 7S-13S (2008)
DOI: 10.1177/0003319707312021


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