Role of sulodexide in the treatment of CVD.

Treatment of vascular diseases should be based on established pathophysiological concepts, and this also applies to chronic venous disease (CVD). On the basis of the latest research in this field, this paper summarizes the most advanced pathophysiological knowledge regarding the hemodynamics of the large veins and of the microcirculation, the endothelial function and inflammation, and the use of sulodexide in the treatment of CVD. The emerging theories on the pathophysiology of CVD consider inflammation, endothelial glycocalyx dysfunction, and the consequent changes in the extracellular matrix to play key roles in the development of CVD, and support a renewed interest in the research and application of sulodexide. As part of active approach to the treatment of CVD including edema and trophic venous alterations, sulodexide could help to alleviate progressive signs and symptoms of disease in any clinical CEAP class of CVD, from C1 to C6.