Nonoperative approach for symptomatic patients with chronic venous disease: results from the VEIN Act program

In patients with chronic venous disease (CVD), there is a variety of symptomatic manifestations, as well as a variety of treatment options available to manage the disease and alleviate the symptoms. Evidence shows that patients benefit from pharmacologic treatment and lifestyle advice to improve quality of life, symptom severity, and ulcer healing. High-quality studies have shown that venoactive drugs, such as micronized purified flavonoid fraction (MPFF) and other flavonoids, are essential tools for healing ulcers and controlling edema. The VEIN Act program served as a worldwide collaboration to study patients with symptomatic CVD (clinical, etiological, anatomical, and pathophysiological (CEAP) classes C-0 to C-6), where medical therapy was offered at the initial office visit. End points of interest included symptom relief after 3 months of noninterventional therapy with venoactive drugs, educational and lifestyle advice, and the use of compression stockings. The results showed that symptoms, including leg heaviness, pain, swelling, and cramps, decreased 3 to 4 points on the visual analog scale at the follow-up visit. Overall patient satisfaction was also recorded, with 72% of patients reporting being "very" or "extremely" satisfied with therapy. These results suggest that, by combining pharmacologic interventions with MPFF, education, and compression stockings, a considerable group of patients can achieve an improvement in their symptoms.