Venous diseases

Pascarella L. 2007. Essentials of Daflon 500 mg from early valve protection to long-term benefits in the management of chronic venous disease. Curr Pharm Des 13 431 —444. 

Prophylactic enoxaparin is given subcutaneously in a dosage of 30 mg twice daily or 40 mg once daily. Full-dose enoxaparin therapy is 1 mg/kg subcutaneously every 12 hours. This corresponds to a therapeutic anti-factor Xa level of 0.5—1 unit/mL. Selected patients may be treated with enoxaparin 1.5 mg/kg once a day, with a target anti-Xa level of 1.5 units/mL. The prophylactic dose of dalteparin is 5000 units subcutaneously once a day therapeutic dosing is 200 units/kg once a day for venous disease or 120 units/kg every 12 hours for acute coronary syndrome. The use of LMW heparins is discouraged or contraindicated in patients with renal insufficiency or body weight greater than 150 kg. 

Thrombomodulin mutations are more important in arterial diseases than in venous diseases. The thrombomodulin polymorphism, G—>A substitution at nucleotide position 127 in the gene, has been studied regarding its relation with the arterial disease. The 25 Thr allele has been reported to be more prevalent in male patients with myocardial infarction than the control population (25). Polymorphism in the thrombomodulin gene promoter (-33 G/A) influences the plasma soluble thrombomodulin levels and causes increased risk of coronary heart disease (26). Carriership of the -33A allele was also reported to cause increased occurrence of carotid atherosclerosis in patients less than 60 years (27). 

Capelli, R., Nicora, M., and Di Perri, T. 1988. Use of extract of Ruscus aculeatus in venous disease in the lower limbs. Drugs Exp. Clin. Res. 14, 277-283. 

Boers GH) (1997) Ftyperhomocysteinemia as a risk factor for arterial and venous disease. 

Allain H, Ramelet AA, Polard E, Bentue-Ferrer D. Safety of calcium dobesilate in chronic venous disease, diabetic retinopathy and haemorrhoids. Drug Saf 2004 27(9) 649-60. 

Buchbinder, D., McCullough, G.M. and Mehck, CTl (1993) Patients evaluated for venous disease may have other pathological considerations contributing to symptomatology. Am J Surg, 166,211-215. 

Uses Diosmin and hidrosmin have been used to treat the pain and bleeding of hemorrhoids [6 , 7 J, in chronic venous disease [8 ], and in chronic lymphedema. Adverse reactions occur in about 10% of patients and lead to dropouts in trials at a rate of about 1 7o [9 ]. They include nausea and epigastric discomfort [lOF] and somnolence [ID],... 

Gohel MS, Davies AH. Pharmacological agents in the treatment of venous disease ... 

Belcaro G, Cesarone MR, Bavera P, Ricci A, Renton S, Leon M, Ippolito E, Dugall M, Acerbi G. HR (Venoruton 1000, Paroven, 0-[beta-hydroxyethyl]-rutosides) vs. Daflon 500 in chronic venous disease and microangiopathy an independent prospective, controlled, randomized trial. J Cardiovasc Pharmacol Ther 2002 7(3) 139-45. 

Small intracutaneous or reticular veins are present in over half of the world s Westernized population (Krijnen et al. 1998). Even without treatment, only a minority of these individuals develop clinically relevant varicosis. Clinically relevant varicose veins which give rise to complaints and complications are present in approximately 10% of the Western population (Madar et al. 1986). Approximately 1% of the population suffers from leg ulceration at some point in their lives (Callam 1992). There is evidence of venous disease in 60% to over 90% of leg ulcers (Callam 1992). 

Brandjes DPM, Biiller HR, Heyboer H, Huisman MV, de Rijk M, Jagt H, ten Cate JW (1997) Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. Lancet 349 759-762 Brantingham CR, Beekman BE, Moss CN, Gordon RB (1970) Enhanced venous pump activity as a result of standing on a varied terrain floor surface. J Occup Med 12 164-169 Callam MJ (1992) Prevalence of chronic leg ulceration and severe chronic venous disease in western countries. Phlebology Suppl 1 6-12... 

Hanley TP, Kiev J, Rice JC, Kerstein MD (1997) Long-term prevention of sequelae of chronic venous disease with graduated-compression stockings. J Vase Surg 31 451-455 Horner J, Fernandez JFE, Nicolaides AN (1980) Value of graduated compression in deep venous insufficiency. BMJ 75 820-821... 

Vicaretti M. Compression therapy for venous disease. Aust Prescr 2010 33(6) 186—90. 

Coon, W.W., Willis 3rd, P.W., Keller, J.B., 1973. Venous thromboembohsm and other venous disease in the Tecumseh community health study. Circulation 48, 839-846. 

Robertson, L., Evans, C., Fowkes, F.G., 2008. Epidemiology of chronic venous disease. Phle-bology 23, 103-111. 

Tran, N.T., Meissner, M.H., 2002. The epidemiology, pathophysiology, and natural history of chronic venous disease. Seminars in Vascular Surgery 15,5-12. 

Nick J. M. London and Richard Donnelly, ABC of Arterial and Venous Disease Ulcerated Lower limb, BMJ 2000 320 1589-1591. 

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