Via practica 3-4/2014

News in the pharmacotherapy of venous disease

Recently, new knowledge has been gained in the field of both chronic and acute venous disease that has an impact on the care of patients with these conditions. The incidence of chronic venous disease has been shown to be globally high, in both industrialized and developing countries. The rate of the most severe cases with an advanced stage of venous failure is approximately twice as high in the population as has been assumed so far. Among venopharmaceuticals, micronized purified flavonoid fraction remains the agent with the highest degree of recommendation and is also indicated to pharmacological support of leg ulcer healing, along with pentoxifylline and sulodexide. The care of patients with venous thromboembolism is laid out in internationally accepted guidelines. In addition to the ACCP Guidelines, a new version of the IUA Consensus has recently been available that better suits the utilization in clinical practice. Novel anticoagulants represent one of the therapeutic and preventive options with a limitation in patients with malignant conditions and in pregnancy. Thrombolytic therapy can be considered in patients with thrombosis in the ileofemoral location. Thromboses of superficial veins longer than 5 cm are indicated to anticoagulant therapy. Aspirin is accepted in secondary prevention of recurrent venous thrombosis after cessation of anticoagulant therapy or in the case of a high risk of bleeding, and can be of significance in dual prevention of venous and arterial thrombosis.

Keywords: venous thrombosis, prevention of TED, chronic venous insufficiency, varices, venous ulcers.