Use of microcirculatory parameters to evaluate foam sclerotherapy treatment of superficial chronic venous disease, associated or not with venotonic drug: randomized, double-blind trial.

Abstract

Background: Chronic venous disease (CVD) is a pathology with unfavorable outcome when treated and/or followed up incorrectly. In addition to macroscopic venous changes, CVD also causes changes in microcirculation. Based on these hypotheses, a non-invasive test to quantify the evolution of microangiopathy may be useful to assess the effects and benefits of treatment.

Methods: Fifty female patients with varicose veins classified by clinical class C2 or C3 of the CEAP classification were selected and allocated randomly in two groups: foam sclerotherapy (FS) + micronized purified flavonoid fraction (MPFF) or FS + placebo, double-blind. Microcirculation was evaluated using Sidestream Dark Field techniques. The revised VCSS score was performed pre and post FS.

Results: It was found an improvement on VCSS and all microcirculation parameters, in both groups, except on the number of pathological capillaries. When comparing the results between groups, a greater reduction in the diameters of dermal papilla was observed in the MPFF group (P=0.053), which, despite not being statistically significant, had an effect size of 0.55 (-0.01-1.10). In addition, capillary bulk and capillary limb also had a higher decrease in the MPFF group.

Conclusions: FS treatment of the trunk veins reduced distal venous hypertension, improving microcirculation in all patients, helping to control the venous disease. All patients got therapeutic success (total occlusion or partial occlusion with improvement in venous reflux or reduction in venous caliber).