Chronic venous diseases (CVD) of the lower extremities is a term used to denote all functional and morphological disorders of the venous system of the lower extremities, which manifest themselves over a long time as a characteristic symptom complex and require therapeutic measures in order to prevent the development of complications. This pathology is detected in 25% of the population of industrially developed countries. Moreover, several decades ago this pathology was attributed to diseases of the older age group (age more than 50 years), now however very young patients go to see a doctor with the first signs of CVD, 10-15% of schoolchildren at the age of 12-13 years show the first signs of venous reflux. Annual costs for treating patients with CVD and their complications in European countries make up about 2% of the total health care budget, in the United States - about $2.5 billion. All this makes CVD an important medical and social problem. The clinical manifestation of chronic venous diseases includes a whole range of complaints and external symptoms: discomfort, pain, feeling of weight, periodic edema of the lower extremities (observed in 76.1% of patients with chronic venous disease), paresthesia, convulsions, a feeling of fullness and burning in the calf muscles. These symptoms are most acute after prolonged static load and in the evening. Regression of the above symptoms is observed after resting in a horizontal position, walking and using various medical devices to compress the lower extremities. The most common manifestation of CVD is the lower extremity saphenous veins dilation, which is well visualized during the initial examination of the patient. In the early stages, patients notice cosmetic skin defects, such as telangiectasia and reticular varicose veins, which cause discomfort to patients from an aesthetic point of view and force them to consult a doctor. At later stages, patients have varicose (nodular) transformation of the saphenous veins (observed in 34.8% of patients with CVD), spreading along the lower leg and thigh. Gradually, trophic disorders develop with hypo- and hyperpigmentation of the skin of the lower leg and lipodermatosclerosis (observed in 40.9% of patients). Without proper treatment, 12–13% of CVD patients subsequently develop venous trophic ulcers that are difficult to treat. This leads to a significant decrease in the quality of life and disability of patients with CVD and requires specialized treatment. Complex treatment of CVD includes pharmacotherapy, compression therapy, as well as physiotherapy and surgical treatment. The main group of drugs for the treatment of patients with chronic venous disease are phlebotonics, which are an extensive group of medicinal products of plant and synthetic origin, the main effect of which is to increase the tone of the venous wall. Taking phlebotonics reduces venous resistance, accelerates venous return, and reduces capillary filtration. The main goals of conservative drug treatment for chronic venous disease are:

Relief of the main symptoms of the disease (reduction of pain syndrome, reduction of edema, fatigue, feeling of weight in the legs, prevention of seizures and paresthesias).

Prevention of CVD complications (trophic disorders, trophic ulcers).

Preoperative preparation, as well as postoperative rehabilitation of patients.

Prevention of CVD development in patients at risk for this disease.

Source: Katorkin S.E., Myshentsev P.N., Lisin O.E., Rozanova A.A.

Comparative assessment of the clinical efficacy of the first generation phlebotonics in the complex treatment of patients with chronic diseases of the veins of the lower extremities. Inpatient replacement technologies: outpatient surgery. 2019; (3-4): 18-25, doi: 10.21518 / 1995-1477-2019-3-4-18-25