Positive effects of Pycnogenol?-Centellicum? on venous elasticity: an ex-vivo concept study

BACKGROUND: The aim of this ex-vivo study was to evaluate the efficacy of Pycnogenol (R)-Centellicum (R) oral supplementation on vein segments, retrieved from graft harvesting or from vein surgery. The parameters assessed were elasticity and recovery after dynamic tests: 1) an enlargement stress; 2) an elongation stress; and 3) elasticity after torsion. The tests were made in standardized conditions, less than 3 hours after explant, at 22 degrees C by the same operator with surgical and microsurgical experience.METHODS: Veins of 59 subjects were included in the study: 17 subjects with normal veins with a planned bypass graft and 42 subjects with varicose veins. Of the subjects with normal veins, 8 subjects followed standard management (group 1) and 9 took Pycnogenol (R)-Centellicum (R) for 4 weeks before surgery (group 2). In the group with varicose veins, 22 subjects served as controls (group 3) and 20 were supplemented with Pycnogenol (R)-Centellicum (R) for 4 weeks before surgery (group 4). No side effects or tolerability problems were observed in the supplementation period before surgery and veins harvesting. The full return to initial shape/sizes after dynamic stress was evaluated in 1 min after removing the stress. RESULTS: In group 1, 4 out of 8 vein segments recovered their size after forced enlargement vs. 7/9 in the Pycnogenol (R)- Centellicum (R) group 2 (P<0.05). In the elongation test, 3/8 normal control vein segments recovered their length (group 1) vs. 7/9 in the supplement group (group 2) (P<0.05). In the torsion test, 4/8 (group 1) veins recovered their shape after torsion vs. 9/9 veins in Pycnogenol (R)-Centellicum (R)-pretreated segments (group 2) (P<0.05). Only 45.8% of normal, control vein segments (group 1) recovered their shape/size in comparison with 85.2% of normal vein segments in the supplement group (group 2) (P<0.05). In group 3 and 4 (segments of varicose veins), the proportion of vein segments with enlargements, elongation and torsion were significantly lower at the end of the test (P<0.05) in the Pycnogenol (R)- Centellicum (R) group 4 with 51.7% of the vein segments recovering their shape in the Pycnogenol (R)-Centellicum (R) vs. 16.6% of the vein segments recovering their shape in control segments (P<0.05). Results show that Pycnogenol (R)- Centellicum (R) supplementation allows vein segments to better return to their original shape/size after a morphological alteration of shape (in different directions). This could be an expression of an improved wall tone and elasticity of the veins. No vein was teared or damaged during the 59 tests indicating that all stresses were well within the normal wall tensile characteristics of the veins.CONCLUSIONS: In this study, Pycnogenol (R)-Centellicum (R) improved vein elasticity in subjects with normal and varicose veins as vein segments were more elastic (able to recover length and shape) and less passively dilated by high pressure or dynamic stresses. This study indicates that the protective effects of Pycnogenol (R)-Centellicum (R) may partially stop passive dilatation of veins to varicose veins over time by improving vein elasticity. Pycnogenol (R)-Centellicum (R) managed vein segments return more rapidly back to the initial dimensions, shapes and diameters after a dynamic stress.