Abstract
BACKGROUND: Varicose veins affect 25% to 40% of adults, with higher prevalence in older populations. Although Vitis vinifera seed extract (VVSE) can alleviate symptoms of venous insufficiency, its effects on venous reflux remain uncertain. We hypothesized that oral VVSE supplementation would significantly reduce venous reflux time compared with lifestyle modifications alone in patients with lower extremity varicose veins. METHODS: This prospective, open-label, randomized controlled trial enrolled adults aged 19 to 80 years with varicose veins and venous reflux confirmed by Doppler ultrasound (≥0.5 seconds in superficial veins or ≥1 second in deep veins). Patients were provided oral VVSE (150 mg twice daily) plus therapeutic lifestyle changes or therapeutic lifestyle changes alone (control) over 12 weeks. The mean venous reflux time, changes in specific vein reflux times, proportion achieving improved reflux (≤0.5 seconds for superficial veins, ≤1 second for deep veins), Venous Clinical Severity Score (VCSS), and Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ-14) score were compared. RESULTS: Among 176 participants (88/group), the VVSE group experienced significantly greater reductions in mean venous reflux time. Improvements were observed in both superficial and deep veins, with notable effects in the great saphenous and popliteal veins. The proportion of patients achieving improved venous reflux was significantly higher in the VVSE group. The VVSE group also demonstrated superior symptom improvement, with greater reductions in VCSS and CIVIQ-14 scores. CONCLUSIONS: VVSE significantly reduced venous reflux time across both superficial and deep veins, improving patient-reported symptoms compared with lifestyle modifications alone. The beneficial effects were consistent across diverse patient subgroups and particularly noteworthy in deep venous insufficiency.