"h specialists and general practitioners have to deal with this disease, there is a need for practical support regarding CVD management in daily practice. This article summarizes the most recent guidelines regarding the place of venoactive drugs (VADs) such as Daflon 500 mg in the management of this disease. In addition, it makes suggestions regarding expected improvements in future guideline documents. INTRODUCTION Chronic venous disease (CVD) of the lower limbs is often characterized by symptoms and signs as a result of structural or functional abnormalities of the veins. Symptoms include"

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"ces pain, causes discomfort, significantly reduces the quality of life for the affected patient, and lacks specific and consensual instruments able to adequately assess its signs and symptoms. This article presents these needs that are still unmet in clinical practice and that relate to the tools currently available for the assessment of the therapeutic efficacy of drugs on the disease symptoms and signs. Suggestions are presented regarding new endpoints and tools to be used in further clinical trials designed to assess the effect of therapies on CVD, in particular studies with Daflon 500 m"

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"nd to serve as a basis for more scientific analysis of treatment options. In addition to improved methods of defining CVD, there is also now increased understanding of the pathological processes involved in its development. Leukocyte-endothelium interactions are one of the earliest pathophysiological mechanisms at work and appear to be important in many aspects of the disease. The sequence of leukocyte adhesion, endothelial interaction, activation, and migration, and its association with valvular damage has focused attention on available molecules with activity known to modify this chain of ev"

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"ge patients with chronic venous disease of the lower extremities. The two important documents, “Management of Chronic Venous Disorders of the Lower Limbs: Guidelines According to Scientific Evidence”1 prepared by an international consensus group under the auspices of the leading societies for venous disease, and, “Antithrombotic Therapy for Venous Thromboembolic Disease,”2 as part of the American College of Chest Physicians (ACCP) 8th consensus conference, have recently been published to help physicians care for patients with venous disease. While there is broad overlap of these two do"

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"ter understanding of the pathophysiology of the condition at the macrocirculatory, microcirculatory, and molecular levels. Although deep vein thrombosis is responsible for some of the most severe forms of chronic venous disease, especially if its treatment is suboptimal, it should be remembered that in most cases, including those with venous ulceration, chronic venous disease is not the result of previous thrombosis, but of chronic changes in the venous wall that damage valves and produce reflux and venous hypertension. The most important advance in understanding chronic venous disease pat"

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"Y Treatment of chronic venous disease of the lower extremities: what’s new in guidelines? A. J. Comerota - Phlebolymphology - 2009; 16 (4): 313 Management of chronic venous disease: the example of Daflon 500 mg A. A. Ramelet - Phlebolymphology - 2009; 16 (4): 321 Unmet needs in the assessment of symptoms and signs related to chronic venous disease. A. Jawien - Phlebolymphology - 2009; 16 (4): 331 Venoactive medications and the place of Daflon 500 mg in recent guidelines on the management of chronic venous disease A. Nicolaides - Phlebolymphology - 2009; 16 (4): 340 "

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