Subscribe to RSS
DOI: 10.1055/s-0033-1363784
Postpartum Varicose Veins: Supplementation with Pycnogenol or Elastic Compression—A 12-Month Follow-Up
Publication History
Publication Date:
29 May 2014 (online)
Abstract
This open registry aimed to evaluate the clinical evolution of postpartum varicose veins (VVs), in healthy women after the second pregnancy, how these veins regain shape and competence, and possible treatments. The registry included two groups of women: (1) those who used elastic compression stockings, and (2) who used an oral venotonic agent (Pycnogenol, 100 mg/d). A total of 12 evaluation targets were established. Minor symptoms were scored in an analogue scale line. A visual analogue scale line evaluated the overall satisfaction relative to elastic compression or Pycnogenol. Overall 133 women completed the registry evaluation with at least 3 months of follow-up. The resulting two registry groups were comparable. At 3 and 6 months in the Pycnogenol group the number of veins and incompetent sites were lower. At 6 months there were 13.3% of patients with edema in controls versus 3.2% in the Pycnogenol group. Spider veins decreased in Pycnogenol patients. Cramps and other minor symptoms were less common in the Pycnogenol group. In both groups there was a significant improvement at 6 months with better results in the Pycnogenol group. The need for treatment was limited with a decreased need for sclerotherapy, surgery, and conservative treatments in the Pycnogenol group. The overall satisfaction was higher among Pycnogenol patients, and compliance was optimal. Re-evaluation at 12 months indicated that the variations in VVs and spider vein clusters and the associated symptoms did not change. Most remodeling appeared to happen within 6 months after the pregnancy. It was concluded that the use of Pycnogenol improves signs/symptoms of postpartum VVs, and venous function and shape seem to return faster to prepartum, physiological pattern with its use.
-
References
- 1 Nicolaides AN ; Cardiovascular Disease Educational and Research Trust; European Society of Vascular Surgery; The International Angiology Scientific Activity Congress Organization; International Union of Angiology; Union Internationale de Phlebologie at the Abbaye des Vaux de Cernay. Investigation of chronic venous insufficiency: A consensus statement (France, March 5-9, 1997). Circulation 2000; 102 (20) E126-E163
- 2 Kasperczak J, Ropacka-Lesiak M, Breborowicz HG. [Definition, classification and diagnosis of chronic venous insufficiency - part II]. Ginekol Pol 2013; 84 (1) 51-55
- 3 Ropacka-Lesiak M, Kasperczak J, Breborowicz GH. Risk factors for the development of venous insufficiency of the lower limbs during pregnancy—part 1 [in Polish]. Ginekol Pol 2012; 83 (12) 939-942
- 4 Somers P, Knaapen M. The histopathology of varicose vein disease. Angiology 2006; 57 (5) 546-555
- 5 Galanaud JP, Laroche JP, Righini M. The history and historical treatments of deep vein thrombosis. J Thromb Haemost 2013; 11 (3) 402-411
- 6 Florjański J, Zalewski J, Tomiałowicz M , et al. The course of pregnancy, delivery and puerperium in women with varices and thrombophlebitis of lower extremities, after application of low molecular weight heparins [in Polish]. Ginekol Pol 2001; 72 (12A) 1291-1295
- 7 Lussana F, Coppens M, Cattaneo M, Middeldorp S. Pregnancy-related venous thromboembolism: risk and the effect of thromboprophylaxis. Thromb Res 2012; 129 (6) 673-680
- 8 O'Connor DJ, Scher LA, Gargiulo III NJ, Jang J, Suggs WD, Lipsitz EC. Incidence and characteristics of venous thromboembolic disease during pregnancy and the postnatal period: a contemporary series. Ann Vasc Surg 2011; 25 (1) 9-14
- 9 Belcaro G, Nicolaides AN, Stansby G. The Venous Clinic. London: Imperial College Press; 1999
- 10 Nicolaides AN, Belcaro G, Chan P. Chronic venous insufficiency. In: Ascher E, Hollier LH, Strandness DE, , et al, eds. Haimovici's Vascular Surgery. 4th ed. Mosby: Cambridge; 1996: 1242-1258
- 11 Belcaro G, Nicolaides AN. Noninvasive Investigations in Vascular Disease. London: Imperial College Press; 2000
- 12 Belcaro G, Cornelli U, Dugall M , et al. Supplements and Greendrugs Studies; New Rules 2013. London and Annecy Panel. Available at: http://www.angiologyonline.com/2013/01/supplements-greendrugs-studies-new.html . Accessed in 2013.
- 13 Belcaro G, Nicolaides AN. A new role for natural drugs in cardiovascular medicine. Angiology 2001; 52 (Suppl. 02) S1
- 14 Vinciguerra G, Belcaro G, Cesarone MR , et al. Cramps and muscular pain: prevention with pycnogenol in normal subjects, venous patients, athletes, claudicants and in diabetic microangiopathy. Angiology 2006; 57 (3) 331-339
- 15 Belcaro G, Cesarone MR, Errichi BM , et al. Venous ulcers: microcirculatory improvement and faster healing with local use of Pycnogenol. Angiology 2005; 56 (6) 699-705
- 16 Errichi BM, Belcaro G, Hosoi M , et al. Prevention of post thrombotic syndrome with Pycnogenol® in a twelve month study. Panminerva Med 2011; 53 (3) (Suppl. 01) 21-27
- 17 Nuzum DS, Gebru TT, Kouzi SA. Pycnogenol for chronic venous insufficiency. Am J Health Syst Pharm 2011; 68 (17) 1589-1590 , 1599–1601
- 18 Cesarone MR, Belcaro G, Rohdewald P , et al. Improvement of signs and symptoms of chronic venous insufficiency and microangiopathy with Pycnogenol: a prospective, controlled study. Phytomedicine 2010; 17 (11) 835-839
- 19 Cesarone MR, Belcaro G, Rohdewald P , et al. Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study. Angiology 2006; 57 (5) 569-576
- 20 Belcaro G, Cesarone MR, Ricci A , et al. Control of edema in hypertensive subjects treated with calcium antagonist (nifedipine) or angiotensin-converting enzyme inhibitors with Pycnogenol. Clin Appl Thromb Hemost 2006; 12 (4) 440-444
- 21 Belcaro G, Cesarone MR, Rohdewald P , et al. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol. Clin Appl Thromb Hemost 2004; 10 (4) 373-377
- 22 Cesarone MR, Belcaro G, Nicolaides AN , et al. Prevention of venous thrombosis in long-haul flights with Flite Tabs: the LONFLIT-FLITE randomized, controlled trial. Angiology 2003; 54 (5) 531-539
- 23 Boisseau MR. Pharmacological targets of drugs employed in chronic venous and lymphatic insufficiency. Int Angiol 2002; 21 (2) (Suppl. 01) 33-39 Review
- 24 Cesarone MR, Belcaro G, Rohdewald P , et al. Comparison of Pycnogenol and Daflon in treating chronic venous insufficiency: a prospective, controlled study. Clin Appl Thromb Hemost 2006; 12 (2) 205-212
- 25 Belcaro G, Cesarone MR, Errichi BM , et al. Venous ulcers: microcirculatory improvement and faster healing with local use of Pycnogenol. Angiology 2005; 56 (6) 699-705
- 26 Mantle D, Wilkins RM, Preedy V. A novel therapeutic strategy for Ehlers-Danlos syndrome based on nutritional supplements. Med Hypotheses 2005; 64 (2) 279-283
- 27 Rohan CP, Badel P, Lun B, Rastel D, Avril S. Biomechanical response of varicose veins to elastic compression: a numerical study. J Biomech 2013; 46 (3) 599-603
- 28 Lattimer CR, Azzam M, Kalodiki E, Geroulakos G. Hemodynamic changes at the saphenofemoral junction during the application of a below-knee graduated compression stocking. Dermatol Surg 2012; 38 (12) 1991-1997
- 29 Cesarone MR, Belcaro G, Agus G , et al. Management of superficial vein thrombosis and thrombophlebitis: status and expert opinion document. Angiology 2007; 58 (Suppl. 01) 7S-14S , discussion 14S–15S
- 30 Leon M, Volteas N, Labropoulos N , et al. The effect of elastic stockings on the elasticity of varicose veins. Int Angiol 1993; 12 (2) 173-177
- 31 Szendro G, Veller M, Fisher C , et al. The effect of elastic compression on the venous tone in patients with varicose veins. Vasa 1992; 21 (2) 198-202
- 32 Ivanitsky GR, Khizhnyak EP, Deev AA, Khizhnyak LN. Thermal imaging in medicine: A comparative study of infrared systems operating in wavelength ranges of 3-5 and 8-12 microm as applied to diagnosis. Dokl Biochem Biophys 2006; 407: 59-63
- 33 Belcaro G, Errichi BM, Laurora G, Cesarone MR, Candiani C. Treatment of acute superficial thrombosis and follow-up by computerized thermography. Vasa 1989; 18 (3) 227-234
- 34 Belcaro G, Chung CH, Di Nardo E , et al. Infrared and ELC thermography in the assessment of the digital rewarming curve after a Finger-Cooling test. A preliminary report. Panminerva Med 1985; 27 (1) 33-38
- 35 Belcaro G, Errichi BM, Laurora G, Cesarone MR, Candiani C. Treatment of acute superficial thrombosis and follow-up by computerized thermography. Vasa 1989; 18 (3) 227-234
- 36 Cesarone MR, Belcaro G, Agus G , et al. Management of superficial vein thrombosis and thrombophlebitis: status and expert opinion document. Angiology 2007; 58 (Suppl. 01) 7S-14S , discussion 14S–15S
- 37 Belcaro G, Cesarone MR, Dugall M , et al. Topical formulation of heparin is effective in reducing the symptoms of superficial venous thrombosis: a monocenter, observer-blind, placebo-controlled randomized study. Panminerva Med 2011; 53 (3) (Suppl. 01) 3-11
- 38 Sternrstein M. Barron's AP Statistics. 7th ed. New York, NY: Barron Educational Series; 2013
- 39 Maxwell C. Clinical Research for All. Cambridge: Cambridge Medical Publications Ltd; 1977
- 40 Boivin P, Hutinel B. Varices and pregnancy. J Mal Vasc 1987; 12 (2) 218-221