{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T17:16:06Z","timestamp":1783703766847,"version":"3.55.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Phlebology"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is no consensus regarding the benefits of venoactive or venotonics drugs such as Micronized Purified Flavonoid Fraction (MPFF) after endovenous therapy. This study aims to address this gap by systematically reviewing the effects of venotonic drugs after endovenous treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review was conducted, encompassing all relevant studies published up to September 1\n                      <jats:sup>st<\/jats:sup>\n                      2024. The inclusion criteria were as follows: (1) Initiation of a venotonic drug within 4\u00a0weeks or on the same day as undergoing endovenous therapy for lower limb veins; (2) The dosage of venotonic was specified; (3) Any classification of Clinical-Etiology-Anatomy-Pathophysiology (CEAP) was included. Exclusion criteria involved studies that focused solely on the effects of venotonics without the use of endovenous therapy techniques.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven studies (four randomized controlled trials, and three cohort studies) involving 1703 (85.9% female) participants were included. The weighted mean age was 41.7 years. Six studies used MPFF, while one study used a combination of diosmin + Centella asiatica+vitamin C. Participants spanned CEAP classifications C1 to C61, with the majority 1210 (71.1%), classified as C1. MPFF showed significant benefits in nine (75.0%) out of 12 assessments when assessed using visual analog scale for pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination of MPFF or diosmin + Centella asiatica + vitamin C with endovenous therapy has been shown to improve pain scores and quality of life compared to groups not receiving venotonics. No studies reported any detrimental effects. However, to establish definitive recommendations regarding the use of venotonics, further randomized, placebo-controlled trials are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02683555251337265","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T08:36:29Z","timestamp":1745397389000},"page":"729-740","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Role of veno-active drugs after endovenous therapy: A systematic review of the current literature"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2124-9580","authenticated-orcid":false,"given":"Fahmi H","family":"Kakamad","sequence":"first","affiliation":[{"name":"University of Sulaimani"},{"name":"Scientific Affairs Department, Smart Health Tower"},{"name":"Kscien Organization for Scientific Research (Middle East Office), Sulaymaniyah, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soran H","family":"Tahir","sequence":"additional","affiliation":[{"name":"University of Sulaimani"},{"name":"Scientific Affairs Department, Smart Health Tower"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana HB","family":"Mohammed Saeed","sequence":"additional","affiliation":[{"name":"University of Sulaimani"},{"name":"Scientific Affairs Department, Smart Health Tower"},{"name":"Cardiology Department, Suleimani Centre for Heart Disease, Sulaymaniyah, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farman J","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Scientific Affairs Department, Smart Health Tower"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilan S","family":"Hiwa","sequence":"additional","affiliation":[{"name":"Scientific Affairs Department, Smart Health Tower"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berun A","family":"Abdalla","sequence":"additional","affiliation":[{"name":"Scientific Affairs Department, Smart Health Tower"},{"name":"Kscien Organization for Scientific Research (Middle East Office), Sulaymaniyah, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman M","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Scientific Affairs Department, Smart Health Tower"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwan N","family":"Hassan","sequence":"additional","affiliation":[{"name":"Scientific Affairs Department, Smart Health Tower"},{"name":"Kscien Organization for Scientific Research (Middle East Office), Sulaymaniyah, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarhang Sedeeq","family":"Abdalla","sequence":"additional","affiliation":[{"name":"Scientific Affairs Department, Smart Health Tower"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawar A","family":"Sofi","sequence":"additional","affiliation":[{"name":"Scientific Affairs Department, Smart Health Tower"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanaa O","family":"Karim","sequence":"additional","affiliation":[{"name":"Scientific Affairs Department, Smart Health Tower"},{"name":"University of Sulaimani"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Gh","family":"Hamasaeed","sequence":"additional","affiliation":[{"name":"Scientific Affairs Department, Smart Health Tower"},{"name":"University of Sulaimani"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavel M","family":"Kareem","sequence":"additional","affiliation":[{"name":"Scientific Affairs Department, Smart Health Tower"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1258\/phleb.2007.007061"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(95)70195-8"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/dth.15238"},{"issue":"4","key":"e_1_3_4_5_2","first-page":"181","article-title":"Can Micronized Purified Flavonoid Fraction (MPFF) improve outcomes of lower extremity varicose vein endovenous treatment? 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