Chronic cerebrovascular disease: the role of venous disorders and the possibility of pathogenetic correction
DOI: 10.32364/25876821202049544551
I.A. Schukin, M.S. Fidler, I.A. Koltsov
Pirogov Russian National Research Medical University, Moscow, Russian Federation
Aim: to evaluate the efficacy and safety of the L-lysine escinate venotropic drug in the treatment of cephalgic, atactic and asthenic syndromes in patients with chronic cerebral ischemia, mainly caused by venous disorders.
Patients and Methods: the study involved 60 patients with a diagnosis of chronic cerebral ischemia with signs of chronic venous insufficiency. All patients were randomly divided into two groups consisting of 30 people. Patients in the main group received L-lysine escinate, and the control group received Vinpocetine. The drugs were administered by intravenous drip for 10 days. A dynamic assessment was performed using a modified subjective scale of asthenia evaluation (MFI-20), 100 mm long visual analogue scale (VAS) for headache, subjective neurological impairment scale (SNIS), and Tinetti test. An ophthalmic examination with an assessment of the fundus vessels and an ultrasound duplex scanning of head vessels (veins) were also conducted.
Results: it was shown that L-lysine escinate therapy showed a statistically more significant reduction in the severity of headache (according to VAS) and an improved stability measured by Tinetti test versus during Vinpocetine treatment. There were no significant differences in the level of asthenia (MFI-20), the severity of emotional disorders, and the SNIS score. Also, the number of patients with dilated fundus veins significantly decreased during treatment in the main group (p<0.05), which was not the case in the control group. According to ultrasound duplex scanning data, the venous flow velocity through the veins of Rosenthal and angular veins during L-lysine escinate therapy was significantly higher (p<0.05) than in patients receiving Vinpocetine.
Conclusion: the inclusion of vasotropic drugs (in particular, the L-lysine escinate venotonic drug) in the treatment regimen of patients with chronic brain ischemia seems appropriate, especially if there are signs of venous insufficiency.
Keywords: systemic venous insufficiency, chronic cerebrovascular disease, venous dyscirculation, glymphatic system, L-lysine escinate, Vinpocetine.
FOR CITATION: Schukin I.A., Fidler M.S., Koltsov I.A. Chronic cerebrovascular disease: the role of venous disorders and the possibility of pathogenetic correction. Russian Medical Inquiry. 2020;4(9):544–551. DOI: 10.32364/25876821202049544551.
About the authors:
Ivan A. Shchukin — Can. of Sci. (Med), Associate Professor of the Department of Neurology and Neurosurgery, Pirogov Russian National Research Medical University: 1, Ostrovityanova str., Moscow, 117997, Russian Federation, ORCID iD 0000-0002-6308-9706.
Mikhail S. Fiedler — Assistant Professor of the Department of Neurology and Neurosurgery, Pirogov Russian National Research Medical University: 1, Ostrovityanova str., Moscow, 117997, Russian Federation, ORCID iD 0000-0001-6464-521X.
Ivan A. Koltsov — Assistant Professor of the Department of Neurology and Neurosurgery, Pirogov Russian National Research Medical University: 1, Ostrovityanova str., Moscow, 117997, Russian Federation, ORCID iD 0000-0002-9900-4073.
Contact information: Ivan A. Shchukin, e-mail: ivashchukin@gmail.com. Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 07.08.2020, revised 20.08.2020, accepted 31.08.2020.
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