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Int J Angiol 2014; 23(01): 047-052
DOI: 10.1055/s-0033-1363785
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Improvements of Venous Tone with Pycnogenol in Chronic Venous Insufficiency: An Ex Vivo Study on Venous Segments

Gianni Belcaro
1   Circulation Science, Irvine3 Labs, CH-PE University, Pescara, Italy
,
Mark Dugall
1   Circulation Science, Irvine3 Labs, CH-PE University, Pescara, Italy
,
Roberta Luzzi
1   Circulation Science, Irvine3 Labs, CH-PE University, Pescara, Italy
,
M. Hosoi
1   Circulation Science, Irvine3 Labs, CH-PE University, Pescara, Italy
,
Marcello Corsi
1   Circulation Science, Irvine3 Labs, CH-PE University, Pescara, Italy
› Author Affiliations
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Publication History

Publication Date:
17 February 2014 (online)

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Abstract

This study evaluated the stretching and dilatation of venous segments ex vivo in subjects with primary varicose veins in comparison with comparable segments from subjects that used the supplement Pycnogenol (150 mg/d) for 3 months before surgery. Subjects with varicose veins and chronic venous insufficiency voluntarily used Pycnogenol for a period of at least 3 months. The segments of veins removed with surgery (in 30 subjects that had used Pycnogenol and in 10 comparable control subjects that had not used the supplement) were compared with normal, unused vein segments harvested for bypass grafting. The segments were suspended and a weight was attached to the distal part of the veins for 3 minutes and dilated with pressurized water. Digital images were recorded; the veins were measured before and after stretching to evaluate elongation. The manipulation of the vein segment was minimal. Tests were completed within 20 minutes after harvesting the veins. All segments were 4 cm long. The stretching test indicated a significantly higher level of passive elongation in control, varicose segments (2.29; 0.65 mm) in comparison with 1.39; 0.2 mm in vein segments from Pycnogenol-using patients. The dilation test showed an average higher dilation (2.19; 0.3 mm) in control varicose veins in comparison with varicose veins from Pycnogenol-using patients (1.32; 0.7 mm) (p < 0.05). Stretching and dilatation were lower in veins from Pycnogenol-using subjects (p < 0.05). The measurement of destretching and the recovery after dilatation indicated a better tone and recovery of the original size/shape in varicose segments from patients using Pycnogenol. Varicose segments had a more significant persistent dilatation and elongation in comparison with normal vein segments. Pycnogenol seems to decrease passive dilatation and stretching and gives vein walls a greater tonic recovery and elasticity that allows the vein to recover its original shape after dynamic stresses.

Keywords

Pycnogenol - chronic venous insufficiency - venous tone - varicose veins
 

  • References

  • 1 Caro CG, Pedley TJ, Schroter RC, Seed WA. The Mechanics of the Circulation. Cambridge: Cambridge University press; 2011
    CrossrefGoogle Scholar
  • 2 Szendro G, Veller M, Fisher C , et al. The effect of elastic compression on the venous tone in patients with varicose veins. Vasa 1992; 21 (2) 198-202
    PubMedGoogle Scholar
  • 3 Belcaro G, Cesarone MR, de Sanctis MT , et al. Laser Doppler and transcutaneous oximetry: modern investigations to assess drug efficacy in chronic venous insufficiency. Int J Microcirc Clin Exp 1995; 15 (Suppl. 01) 45-49
    CrossrefPubMedGoogle Scholar
  • 4 Petruzzellis V, Troccoli T, Candiani C , et al. Oxerutins (Venoruton): efficacy in chronic venous insufficiency—a double-blind, randomized, controlled study. Angiology 2002; 53 (3) 257-263
    CrossrefPubMedGoogle Scholar
  • 5 Bertrand-Thiebault C, Ferrari L, Boutherin-Falson O , et al. Cytochromes P450 are differently expressed in normal and varicose human saphenous veins: linkage with varicosis. Clin Exp Pharmacol Physiol 2004; 31 (5-6) 295-301
    CrossrefPubMedGoogle Scholar
  • 6 Svedman C, Cherry GW, Ryan TJ. The veno-arteriolar reflex in venous leg ulcer patients studied by laser Doppler imaging. Acta Derm Venereol 1998; 78 (4) 258-261
    CrossrefPubMedGoogle Scholar
  • 7 Belcaro G, Nicolaides AN, Stansby G. The Venous Clinic. London: Imperial College Press; 2001
    Google Scholar
  • 8 Belcaro G, Veller M, Nicolaides AN. Venous Disorders. A Manual of diagnosis and Treatment. London: Saunders; 1999
    Google Scholar
  • 9 Belcaro G, Nicolaides AN. Non invasive investigations in vascular disease. London: Imperial College Press; 2001
    Google Scholar
  • 10 Belcaro G, Hofman U, Bollinger A, Nicolaides AN. Laser Doppler. London: MedOrion; 1996
    Google Scholar
  • 11 Belcaro G, Taccoen A. Venous wall perfusion. In: Intern Union Phlebologie. London: International Union of Angiology; ; 1197. Abstract 122
    Google Scholar
  • 12 Belcaro G, Laurora G, Cesarone MR , et al. Vasa vasorum visualised by power-Doppler in normal and arteriosclerotic carotid arteries. Vasa 1996; 25 (3) 226-232
    PubMedGoogle Scholar
  • 13 Taccoen A, Belcaro G, Lebard C, Zuccarelli F. Etiologies et mécanismes des varices: réalités et perspectives. Sang Thrombose Vaisseau. 1997; 9: 354-363
    PubMedGoogle Scholar
  • 14 Belcaro G, Hu S, Hosoi M. Circulation Sciences. Pycnogenol into the venous wall. Physiology and chromatography. Circulation Sciences Journal 2010; 13: 18
    PubMedGoogle Scholar
  • 15 Belcaro G, Cesarone MR, Errichi BM , et al. Venous ulcers: microcirculatory improvement and faster healing with local use of Pycnogenol. Angiology 2005; 56 (6) 699-705
    CrossrefPubMedGoogle Scholar
  • 16 Errichi BM, Belcaro G, Hosoi M , et al. Prevention of post thrombotic syndrome with Pycnogenol® in a twelve month study. Panminerva Med 2011; 53 (3) (Suppl. 01) 21-27
    PubMedGoogle Scholar
  • 17 Nuzum DS, Gebru TT, Kouzi SA. Pycnogenol for chronic venous insufficiency. Am J Health Syst Pharm 2011; 68 (17) 1589-1590 , 1599–1601
    CrossrefPubMedGoogle Scholar
  • 18 Cesarone MR, Belcaro G, Rohdewald P , et al. Improvement of signs and symptoms of chronic venous insufficiency and microangiopathy with Pycnogenol: a prospective, controlled study. Phytomedicine 2010; 17 (11) 835-839
    CrossrefPubMedGoogle Scholar
  • 19 Cesarone MR, Belcaro G, Rohdewald P , et al. Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study. Angiology 2006; 57 (5) 569-576
    CrossrefPubMedGoogle Scholar
  • 20 Belcaro G, Cesarone MR, Ricci A , et al. Control of edema in hypertensive subjects treated with calcium antagonist (nifedipine) or angiotensin-converting enzyme inhibitors with Pycnogenol. Clin Appl Thromb Hemost 2006; 12 (4) 440-444
    CrossrefPubMedGoogle Scholar
  • 21 Belcaro G, Cesarone MR, Rohdewald P , et al. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol. Clin Appl Thromb Hemost 2004; 10 (4) 373-377
    CrossrefPubMedGoogle Scholar
  • 22 Cesarone MR, Belcaro G, Nicolaides AN , et al. Prevention of venous thrombosis in long-haul flights with Flite Tabs: the LONFLIT-FLITE randomized, controlled trial. Angiology 2003; 54 (5) 531-539
    CrossrefPubMedGoogle Scholar
  • 23 Boisseau MR. Pharmacological targets of drugs employed in chronic venous and lymphatic insufficiency. Int Angiol 2002; 21 (2) (Suppl. 01) 33-39
    PubMedGoogle Scholar
  • 24 Cesarone MR, Belcaro G, Rohdewald P , et al. Comparison of Pycnogenol and Daflon in treating chronic venous insufficiency: a prospective, controlled study. Clin Appl Thromb Hemost 2006; 12 (2) 205-212
    CrossrefPubMedGoogle Scholar
  • 25 Belcaro G, Cesarone MR, Errichi BM , et al. Venous ulcers: microcirculatory improvement and faster healing with local use of Pycnogenol. Angiology 2005; 56 (6) 699-705
    CrossrefPubMedGoogle Scholar
  • 26 Vinciguerra G, Belcaro G, Cesarone MR , et al. Cramps and muscular pain: prevention with pycnogenol in normal subjects, venous patients, athletes, claudicants and in diabetic microangiopathy. Angiology 2006; 57 (3) 331-339
    CrossrefPubMedGoogle Scholar
  • 27 Doherty GM. Current Surgical Diagnosis and Treatment, 12th ed. New York, NY: McGraw Hill; 2003
    Google Scholar
  • 28 Nicolaides AN ; Cardiovascular Disease Educational and Research Trust; European Society of Vascular Surgery; The International Angiology Scientific Activity Congress Organization; International Union of Angiology; Union Internationale de Phlebologie at the Abbaye des Vaux de Cernay. Investigation of chronic venous insufficiency: A consensus statement (France, March 5-9, 1997). Circulation 2000; 102 (20) E126-E163
    CrossrefPubMedGoogle Scholar
  • 29 Kasperczak J, Ropacka-Lesiak M, Breborowicz HG. Definition, classification and diagnosis of chronic venous insufficiency - part II [in Polish]. Ginekol Pol 2013; 84 (1) 51-55
    PubMedGoogle Scholar
  • 30 Ropacka-Lesiak M, Kasperczak J, Breborowicz GH. Risk factors for the development of venous insufficiency of the lower limbs during pregnancy—part 1 [in Polish]. Ginekol Pol 2012; 83 (12) 939-942
    PubMedGoogle Scholar
  • 31 Somers P, Knaapen M. The histopathology of varicose vein disease. Angiology 2006; 57 (5) 546-555
    CrossrefPubMedGoogle Scholar
  • 32 Thulesius O. Physiology of veins and their relationship with venous disorders. In: Belcaro G, Veller M, Nicolaides AN, , eds. Venous Disorders. A Manual of diagnosis and Treatment. London: Saunders; 1999
    Google Scholar
  • 33 Clarke GH. Venous Elasticity [dissertation]. London: University College; 1989
    Google Scholar
  • 34 Beckwith T, Clarke GH, Richardson GA. Correlation between blood flow volume and ultrasonic Doppler wave forms in the study of valve efficiency. In: Intern Union Phlebologie. International Union of Angiology (London); 1991. Abstract 23
    Google Scholar
  • 35 Clarke H, Smith SRG, Vasdekis SN, Hobbs JT, Nicolaides AN. Role of venous elasticity in the development of varicose veins. Br J Surg 1989; 76 (6) 577-580
    CrossrefPubMedGoogle Scholar
  • 36 Clarke GH, Vasdekis SN, Hobbs JT, Nicolaides AN. Venous wall function in the pathogenesis of varicose veins. Surgery 1992; 111 (4) 402-408
    PubMedGoogle Scholar
  • 37 Hosoi Y, Zukowski A, Kakkos SK, Nicolaides AN. Ambulatory venous pressure measurements: new parameters derived from a mathematic hemodynamic model. J Vasc Surg 2002; 36 (1) 137-142
    CrossrefPubMedGoogle Scholar
  • 38 Zukowski AJ, Nicolaides AN, Szendro G , et al. Haemodynamic significance of incompetent calf perforating veins. Br J Surg 1991; 78 (5) 625-629
    CrossrefPubMedGoogle Scholar
  • 39 Nicolaides AN, Zukowski AJ. The value of dynamic venous pressure measurements. World J Surg 1986; 10 (6) 919-924
    CrossrefPubMedGoogle Scholar
  • 40 Grimm T, Schäfer A, Högger P. Antioxidant activity and inhibition of matrix metalloproteinases by metabolites of maritime pine bark extract (pycnogenol). Free Radic Biol Med 2004; 36 (6) 811-822
    CrossrefPubMedGoogle Scholar
  • 41 Grimm T, Chovanová Z, Muchová J , et al. Inhibition of NF-kappaB activation and MMP-9 secretion by plasma of human volunteers after ingestion of maritime pine bark extract (Pycnogenol). J Inflamm (Lond) 2006; 3: 1
    CrossrefPubMedGoogle Scholar
  • 42 Fitzpatrick DF, Bing B, Rohdewald P. Endothelium-dependent vascular effects of Pycnogenol. J Cardiovasc Pharmacol 1998; 32 (4) 509-515
    CrossrefPubMedGoogle Scholar
  • 43 Ivanov V, Ivanova S, Roomi MW, Kalinovsky T, Niedzwiecki A, Rath M. Extracellular matrix-mediated control of aortic smooth muscle cell growth and migration by a combination of ascorbic acid, lysine, proline, and catechins. J Cardiovasc Pharmacol 2007; 50 (5) 541-547
    CrossrefPubMedGoogle Scholar