Objective. To evaluate the effects of sulodexide (Vessel Due F), endovenous laser ablation (EVLA), and their combination on the dynamics of endothelial dysfunction and venous-specific inflammatory biomarkers in patients with chronic venous disease (CVD) of the lower extremities classified as CEAP C4—C6. Materials and Methods. Ninety-three patients with CVD (CEAP classes C4—C6) were enrolled in the study. Patients were allocated into four groups: (1) compression therapy; (2) EVLA; (3) sulodexide (Vessel Due F) 250 LSU twice daily for 2 months; and (4) EVLA followed by sulodexide at the same dosage. Serum levels of E-selectin, MCP-1, VEGF, MMP-2, and MMP-9 were measured using quantitative enzyme-linked immunosorbent assay at baseline (V0), 2 months (V2), and 12 months (V3). Results. In the compression group, a moderate reduction in E-selectin was observed at 2 months (60.7±2.8 → 56.6±2.5; p0.05). In the EVLA group, a marked early decrease in E-selectin (66.2±3.1 → 40.8±2.9; p0.05). In the sulodexide group, MCP-1 (205.4±8.7 → 134.6±7.2; p0.05). In the EVLA+sulodexide group, E-selectin significantly decreased at 2 months (67.4±3.5 → 55.8±3.0; p0.05). Conclusion. Vessel Due F was associated with significant reductions in MCP-1 and matrix metalloproteinases, with the most sustained decreases in MCP-1, E-selectin, MMP-2, and MMP-9 observed in the combined treatment group (EVLA+sulodexide). In patients with CVD classified as CEAP C4—C6, compression therapy demonstrated minimal impact on systemic inflammatory and remodeling biomarkers. EVLA provided a pronounced early reduction in endothelial activation (E-selectin) and inflammatory activity (MCP-1), although partial attenuation of this effect was observed at long-term follow-up. Serum VEGF levels did not change significantly in this cohort.
Suchkov et al. (Wed,) studied this question.