The place of micronized purified flavonoid fraction in the management of chronic venous disease from an international guidelines' perspective

Chronic venous disease (CVD) is a highly prevalent disorder with a broad spectrum of symptoms determined by disease stage and whether there is deep or superficial venous system compromise. The treatment goal for CVD is to slow and prevent disease progression and provide symptomatic relief. Available options range from conservative mechanical strategies such as leg elevation, compression stockings, and daily exercise programs to complex surgical deep valvular implants. The adequate treatment option is selected according to the disease phase, and clinicians can add further options as the disease severity progresses. Additionally, pharmacological treatment plays an essential role in CVD management, especially micronized purified flavonoid fraction (MPFF), a venoactive drug (VAD) with proven effectiveness and safety from early stages in C1 patients to complex C6 patients with severe ulcerations. Utilizing MPFF for CVD improves patients' quality of life, symptoms severity, and ulceration healing. MPFF has been widely adopted by vascular practitioners and included in CVD management guidelines worldwide. Therefore, we reviewed several CVD management guidelines published by prestigious academic associations around the globe and summarized their recommendations about the use of MPFF and their level of evidence, providing clinicians with a straightforward and practical source document to include MPFF in daily practice.