Abstract
Vitis vinifera seed extract reduces venous reflux time in patients with varicose veins: Victory randomized controlled trial
Bae S, Kim H, Son NH, Kim M, Park S, Jung IH. J Vasc Surg Venous Lymphat Disord. 2026 Jan; 14(1):102355. doi: 10.1016/j.jvsv.2025.102355. Epub 2025 Nov 15. PMID: 41242464.
The authors evaluated Vitis vinifera seed extract (VVSE) to determine its effects on venous reflux. VVSE contains proanthocyanidins, which are flavonoids that exhibit antioxidant and venoactive properties. The authors undertook a prospective, open-label, randomized controlled trial in adults with confirmed superficial or deep vein reflux. The comparison groups were VVSE + lifestyle changes versus lifestyle changes alone, and the evaluation was done for 12 weeks. The endpoints included reflux time parameters, venous clinical severity score (VCSS), and Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ-14) score.
They screened 205 individuals and recruited 176 participants (88 in each group). The average age was 43.4 years and 75.6% were women. The VVSE group experienced improved reflux time parameters. The adjusted change from baseline was greater in the VVSE group, −3599 ms versus −1109 ms, P < .001. There were significant improvements in reflux time for both superficial and deep vein reflux. Relating to symptom improvement, VCSS decreased preferentially by −3.95 points versus −1.81 points, P < .001. This was corroborated by the CIVIQ-14 which improved by −6.97 points versus −2.97 points, P < .001.
The authors concluded that VVSE may serve as an important non-invasive adjunct in improving venous reflux in both superficial and deep veins, as well as improving patient reported outcomes.
A nutraceutical intervention for alleviating tired and heavy legs in healthy subjects: A randomized, double-blind, controlled study
Nobile V, Cestone E, Roveda G. BMC Nutr. 2025 Nov 10; 11(1):207. doi: 101186/s40795-025-01184-1. PMID: 41214827.
The authors evaluated a food supplement that contains 570 mg of a flavonoid complex with 80% diosmin. Diosmin is primarily found in citrus, with antioxidant and circulatory effects. In an animal study, the product (μsmin® Plus, Giellepi, S.p.A) demonstrated increased bioavailability compared to micronized diosmin. This study was a randomized, double-blind, placebo-controlled study using the diosmin supplement with patients presenting with heavy and tire legs and with telangiectasias (C1 category of CEAP). The study was carried out to 56 days. Outcomes included clinical assessment of leg symptoms, as well as resolution of telangiectasias.
165 patients were screened, and 124 were randomized with eventual enrollment of 57 in the treatment group and 60 in the placebo group. The average age was 49.0 versus 48.5 years, P = NS. At 56 days, heavy leg sensation improved by 41.7% versus 32.8%, P < .05, and tired leg sensation improved by 45.2% versus 32.1%, P < .05. Telangiectasias improved in the treatment group and worsened in the placebo group. Colorimeter measurements of telangiectasias demonstrated improvement in the treatment group and without change in the placebo group. Self-assessment parameters including global satisfaction, legs with more energy, decrease of heavy legs, discomfort reduction, improvement of skin appearance and feeling better all improved in the treatment group.
The authors concluded that the tested diosmin formulation resulted in improved symptoms and improved skin coloration associated with telangiectasias in patient limbs categorized as C1. The use of non-validated efficacy measurements warrants further study to more concretely establish the efficacy of diosmin for improving symptoms and appearance in patients with telangiectasias.
Additional oxerutin therapy to promote deep vein thrombus resolution (RESOLVE-DVT): A randomized controlled pilot trial
Iding AFJ, Hupperetz RD, Brans RJB, 10 Cate H, van Twist DJL, Ten Cate-Hoek AJ. J Thromb Haemost. 2026 Feb;24(2):644-653. doi: 10.1016/j.jtha.2025.10.018. Epub 2025 Nov 4. PMID: 41197809.
The authors evaluated the effectiveness of oxerutin in patients with residual venous obstruction (RVO) after an acute central deep vein thrombosis (DVT). Oxerutin (O-β-hydroxyethyl-rutoside) is a rutoside with anti-inflammatory and endothelial-protective properties, and it is administered daily as a 500 mg tablet. Standard treatment included anticoagulation with direct oral anticoagulants (DOACs) for 3 months, with elastic compression therapy for at least 6 months. This was a single-center, patient-unblinded, physician-blinded, assessor-blinded randomized controlled trial where within 48 h, patient received a 2-months course of oxerutin in addition to standard treatment versus standard treatment alone. Outcomes included 3-months RVO, as well as Villalta scores, quality of life scores, and biomarkers (C-reactive protein (CRP), intercellular adhesion molecule 1 (ICAM-1), interleukin-6 (IL-6), and IL-10, as well as eight other potential biomarkers.
222 patients were screened, and 44 patients were randomized with 21 versus 22 in the treatment and comparison groups. The average age was 63.9 versus 60.0 years, with 40.9% versus 22.7% females. No adverse events were noted. RVO great than 2 mm was observed in 42.9% versus 59.1%, and RVO greater than 4 mm was observed in 28.6% versus 54.5%, the latter which was statistically significant. A Villalta score of great than five demonstrated a trend towards being lower in the treatment group, 28.6% versus 40.9%. Relating to the biomarkers, most of them reduced the most during the first week with ongoing reductions as compared to control. ICAM-1 levels appeared to increase, but with less of an increase in the treatment group. Ankle and calf circumference improved more in the treatment group (−3.3% vs −1.5%). Quality of life scores (including VEINES-QoL: +3.1 vs +1.6) demonstrated greater improvement in the treatment group.
The authors concluded that oxerutin, in addition to therapeutic anticoagulation and compression treatment, could promote thrombus resolution after acute DVT, and this correlated to improved RVO and a lower incidence of PTS, and this was further corroborated by improved biomarkers. This study supports conducting a larger scale trial of oxerutin in the management of acute DVT.
Efficacy of complex decongestive therapy on venous flow, internal saphenous diameter, edema, fat mass of the limbs and quality of life in patients with chronic venous insufficiency: A randomized clinical trial
Martín Jiménez AM, Bermejo Gil BM, Santos-Lozano A, Pinto-Fraga FJ, García Barroso C, Vittori LR, Fraino A, Menéndez Alegre H. J Vasc Surg Venous Lymphat Disord. 2025 Mar;13(2):102005. doi: 10.1016/j.jvsv.2024.102005. Epub 2024 Nov 13. PMID: 39542398.
The authors evaluated the efficacy of complex decongestive therapy in patients with chronic venous insufficiency. Complex decongestive therapy (CDT) consists of manual lymphatic drainage, intermittent pneumatic presotherapy, and bilayer bandage treatments. This was a single-blinded randomized controlled trial of CDT compared to a control group. Outcomes were obtained at 6 weeks and included Chronic Venous Insufficiency Quality of Life (CIVIQ-20), edema, venous flow and impedance measurements.
25 patients were screened, and 21 were randomized, with 12 in the CDT treatment group and nine in the control group. Different practitioners obtained the follow-up data to maintain an element of blinding. The average age was 54.8 years, and 20/21 patients were female. Most patients had C3 (61.93%) or C4 (33.33%) disease, with only 4.76% with C2 disease. Heaviness and pain improved in a sustained manner. CIVIQ-20 scores improved at 1 week but were not sustained at 6 weeks, and this was consistent with some of the other quality of life measurements. Impedance measurements did not change. BMI and fat mass (FM) improved after 6 weeks of treatment. Deep vein flow rates remained unchanged, but left femoral vein and saphenous vein diameters improved in the treatment groups.
The authors concluded that CDT enhances the quality of life, and alleviates pain and heavinesss, with improved venous parameters and decreases in BMI and FM; however, some lack of sustainability at 6 weeks. This may also have aesthetic implications. Larger and longer-term studies are required.
Imaging-based approach to venous-origin chronic pelvic pain
Moosa V, Ni T, Friedman I, Brown AD. Can Assoc Radiol J 2025 Nov;76(4):782-792.
The authors conducted a comprehensive review of the imaging that is available for patients with venous origin chronic pelvic pain (CPP). The authors discuss the imaging available, including duplex ultrasound, as the first modality. Then, computed tomography and or magnetic resonance venography, which delineates the anatomy and surrounding structures. The authors further discuss the gold standard in diagnosis and intervention which continues to be venography.
The authors conclude that the importance of a multimodal approach to patient care is crucial for early recognition and intervention in patients with CPP.
The usefulness of transvaginal ultrasonography in the diagnosis of pelvic venous disorders
Szkodziak F, Woźniak S, Kudła M, Rogowska-Malicka P, Szkodziak P, Paszkowski M, Pyra K, Paszkowski T. Sci Rep 2025 Jul 9;15(1):24776.
Patients who present with pelvic pain are initially studied with transvaginal ultrasound (TVUS) in the office setting. The authors conducted a cross-sectional observational study of 197 patients. Pelvic venography was performed in 195 patients who met the criteria for PeVD based on ultrasound. If the patient had one, two or three parameters for PeVD, venography confirmed the TVUS findings in 95-96%. If the patients had four positive US parameters, venography confirmed PeVD in 100%.
The authors concluded that TVUS identifies patients with PeVD.
MicroRNA expression in chronic venous leg ulcers and implications for wound healing: A scoping review
Rezende de Carvalho M, Yang H, Stechmiller J, Lyon DE.. Bial Res Nurs. 2025 Apr;27(2):339-351.
The authors did a literature review to better understand the role of microRNAs (miRNAs) in chronic venous ulcers. They found results showing overexpression of certain miRNAs in angiogenesis, other miRNAs that are associated with local inflammatory response, keratinocyte proliferation, impaired healing, and those that promote wound healing.
The authors do suggest the need for more directed research to better understand what targeted therapies may potentially be helpful.
Effects of neuromuscular electrical stimulation on symptoms of chronic venous disease of the lower limbs: A systematic review
Santos M, Pires R, Ferreira J, Dias-Neto M. Vasc Med. 2026 Feb;31(1):114-123.
The authors conducted a review to better elucidate if neuromuscular electrical stimulation (NMES) is effective in relieving symptoms associated with chronic venous disease. The authors looked at peripheral edema, quality of life, venous ulcer healing, and pain.
The authors found that while NMES may positively effect outcomes, they do state that there may be some selection bias and imperfect study design.