Use of microcirculatory parameters to evaluate clinical treatments of chronic venous disorder (CVD)

• Published in: Microvascular research 2008-05, Vol.76 (1), p.66-72
• Main Authors: Lascasas-Porto, Carmen Lucia, Milhomens, Ana Letícia M., Virgini-Magalhães, Carlos Eduardo, Fernandes, Fabiano F.A., Sicuro, Fernando L., Bouskela, Eliete
• Format: Article
• Language: English
• Subjects: Adult; Ascorbic Acid - therapeutic use; Capillaries - pathology; Capillaries - physiopathology; Capillary loop diameter; Capillary morphology; Chronic venous disorder; Chymotrypsin - therapeutic use; Combined Modality Therapy; Cutaneous microcirculatory changes; Cytoscan; Drug Combinations; Edema - pathology; Edema - therapy; Female; Hesperidin - therapeutic use; Humans; Leg - pathology; Leg - physiopathology; Microcirculation - physiopathology; Middle Aged; Orthogonal polarized spectral imaging; Phytosterols - therapeutic use; Plant Extracts - therapeutic use; Stockings, Compression; Treatment Outcome; Trypsin - therapeutic use; Venous Insufficiency - pathology; Venous Insufficiency - physiopathology; Venous Insufficiency - therapy; Venous Thrombosis - pathology; Venous Thrombosis - therapy
• ISSN: 0026-2862; 1095-9319
• DOI: 10.1016/j.mvr.2008.02.002

To evaluate changes on cutaneous microangiopathy in chronic venous disorder (CVD) after use of Cirkan® [venotonic drug containing Ruscus aculeatus (plant extract), hesperidine methylchalcone (flavonoid) and vitamin C], elastic compression stockings (ECS) or no treatment for four weeks. Fifty-five female patients (85 legs), 25 to 57 years, with at least one limb classified as C2,s or C2,3,s (CEAP classification), were allocated consecutively, according to entrance order, in these three groups. Ten healthy women age-matched were also investigated. Using orthogonal polarization spectral technique (noninvasive method), measurements of functional capillary density (FCD, number of capillaries with flowing red blood cells/mm 2), capillary morphology (CM, % of abnormal capillaries/mm 2) and diameters (μm) of dermal papilla (DDP), capillary bulk (DCB) and capillary limb (CD) were obtained on the medial perimalleolar region and later analyzed using CapImage software. CVD patients showed significant changes on CD and CM compared to healthy subjects in agreement with our previous findings (J Vasc Surg 43:1037–1044, 2006). On Cirkan®-treated patients, after 4 weeks, CD decreased on both limbs and CM improved on the left one, suggesting an amelioration of the chronic venous hypertension. No significant changes could be detected on other patient groups. These results confirm the existence of microcirculatory dysfunction in early stages of CVD, probably due to post-capillary hypertension, and further support the venotonic action of Cirkan®.