Phlebotropic therapy for early chronic venous diseases: The first clinical experience with a fixed-dose Ruscus aculeatus extract combination

Introduction. Reticular vein (RV) dilation and telangiectasia (TAE) in the pure form occur in 26% of patients with chronic venous diseases (CVD), mainly affecting female gender.

Aim. To evaluate the efficacy and safety of the novel phlebotropic drug Cyclo 3® Fort (a fixed-dose combination of Ruscus aculeatus extract, hesperidin methyl chalcone, and ascorbic acid) for the elimination of vein-specific symptoms in patients with initial presentations of venous pathology (CEAP C0S and C1S) in the summer months.

Materials and methods. An open-label observational study was conducted in the period from May to September 2025. One hundred thirty women aged 18 to 45 years (mean age 32.2 ± 3.1 years) were randomly selected. Seventy female patients (53.8%) had venospecific complaints and no external or ultrasound imaging findings of vein injuries, while 60 (46.2%) had dilated reticular veins (RV) and transient ischemic attacks (TIA) in both lower limbs. The patients were divided into two groups of 65 patients each (35 with C0S and 30 with C1S). Group 1 received Cyclo 3® Fort, while Group 2 received lifestyle modification recommendations, including the use of percutaneous phlebological drugs. The total observation period was 90 days.

Results. In Group 1, a third of patients did not exhibit any identifiable signs of the disease, which was excluded from the CEAP classification, while 25 (83.3%) women with class C1S transitioned to CEAP clinical class C1. In Group 2, disease transition from class C0S to C0A was observed in 15 patients (42.9%), and from C1S to C1A in 8 patients (26.7%). Photoplethysmography (PPG) results showed that in Group 1 the venous refilling time increased from (22.4 ± 2.4) seconds to (26.3 ± 1.2) seconds, and the calf muscle-venous pump performance increased from (3.9 ± 1.4) % to (6.4 ± 1.1) % (p < 0.001). In Group 2, PPG findings showed no significant changes.

Conclusion. The study demonstrated the safety and efficacy of Cyclo 3® Fort in reducing vein-specific symptoms at the initial stages of CVD and improving the elastic rebound properties of the venous wall.

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