Chronic venous diseases in obese patients: treatment and prevention strategies

This review presents an analysis of publications on chronic venous diseases in patients with obesity (body mass index ≥ 30.0 kg/m²). The data were searched in the Pubmed and Cochrane database. Studies have shown that obesity is a significant risk factor not only for the onset of chronic venous disorders but also for the occurrence of complications and relapses after minimally invasive treatments. In this context, bariatric surgery is gaining popularity, as weight reduction has been shown to correlate with improvements in the clinical severity of chronic venous disease. There is growing interest in pharmacotherapy for this category of comorbid patients. The complex effect combination of bioflavonoids hesperidin and diosmin leads to reduction in venous symptoms. Hesperidin has been proven to have anti-inflammatory, angioprotective, andlipid-lowering properties. It can prevent weight gain and reduce the severity of visceral obesity. Phlebotropic therapy with Venarus® at a daily dose of 1000 mg (100 mg of hesperidin and 900 mg of diosmin) has demonstrated potential for effective use not only in conservative management of chronic venous diseases in patients with overweight and obesity, but also in comprehensive treatment protocols before and after bariatric surgery. Fixed dosages of the two components of the drug Venarus® contribute to a stable therapeutic effect. We present a clinical case report to illustrate the impact of bariatric surgeries on the course of chronic venous disease in the immediate postoperative period: patient M., 42 years old, weight 127 kg, BMI 49 kg/m², CEAP 4b chronic venous disease, who underwent laparoscopic longitudinal gastric resection. In the postoperative period, the patient received pharmacotherapy with Venarus® at a dose of 1000 mg once a day for 3 months, and was recommended to use class 2 compression stockings.

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