Injection sclerotherapy for varicose veins
- 18 October 2006
- journal article
- research article
- Published by Wiley in Cochrane Database of Systematic Reviews
- No. 4,p. CD001732
- https://doi.org/10.1002/14651858.cd001732.pub2
Abstract
Injection sclerotherapy is widely used for superficial varicose veins. The treatment aims to obliterate the lumen of varicose veins or thread veins. There is limited evidence regarding its efficacy. To determine whether sclerotherapy is effective in improving symptoms and cosmetic appearance and has an acceptable complication rate; to define rates of symptomatic or cosmetic varicose vein recurrence following sclerotherapy. We searched the Cochrane Peripheral Vascular Diseases Group trials register (April 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2006), MEDLINE and EMBASE (both inception to April 2006) and reference lists of articles. Manufacturers of sclerosants were contacted for additional trial information. Randomised controlled trials (RCTs) of injection sclerotherapy versus graduated compression stockings (GCS) or 'observation', or comparing different sclerosants, doses, formulations and post-compression bandaging techniques on people with symptomatic and/or cosmetic varicose veins or thread veins were considered for inclusion in the review. Data were extracted by authors and Review Group Co-ordinators independently. Seventeen studies were included. One study comparing sclerotherapy to GCS in pregnancy found that sclerotherapy improved symptoms and cosmetic appearance. Three studies comparing sodium tetradecyl sulphate (STD) to alternative sclerosants found no significant differences in outcome or complication rates; another study found that sclerotherapy with STD led to improved cosmetic appearance compared with polidocanol, although there was no difference in symptoms. Sclerosant plus local anaesthetic reduced the pain from injection (one study) but had no other effects. Two studies compared foam- to conventional sclerotherapy; one found no difference in failure rate or recurrent varicose veins; a second showed short-term benefit from foam in terms of elimination of venous reflux. The recanalisation rate was no different between the two treatments. One study comparing Molefoam and Sorbo pad pressure dressings found no difference in erythema or successful sclerosis. The degree and duration of elastic compression had no significant effect on varicose vein recurrence rates, cosmetic appearance or symptomatic improvement. Evidence from RCTs suggests that the choice of sclerosant, dose, formulation (foam versus liquid), local pressure dressing, degree and length of compression have no significant effect on the efficacy of sclerotherapy for varicose veins. The evidence supports the current place of sclerotherapy in modern clinical practice, which is usually limited to treatment of recurrent varicose veins following surgery and thread veins. Surgery versus sclerotherapy is the subject of a further Cochrane Review.Keywords
This publication has 36 references indexed in Scilit:
- Surgery versus sclerotherapy for the treatment of varicose veinsCochrane Database of Systematic Reviews, 2004
- Injection sclerotherapy for varicose veinsPublished by Wiley ,2002
- Interventions for varicosities and leg oedema in pregnancyPublished by Wiley ,1998
- Epidemiology of varicose veinsBritish Journal of Surgery, 1994
- Randomised trial of bandaging after sclerotherapy for varicose veins.BMJ, 1980
- The value of different forms of treatment for varicose veinsBritish Journal of Surgery, 1979
- VARICOSE VEINS: A COMPARISON OF SURGERY AND INJECTION/COMPRESSION SCLEROTHERAPY: Five-year Follow-upThe Lancet, 1978
- A clinical trial designed to discover if the primary treatment of varicose veins should be by Fegan's method or by an operationBritish Journal of Surgery, 1975
- The management of varicose veinsBritish Journal of Surgery, 1973
- The Economics of Treating Varicose VeinsInternational Journal of Epidemiology, 1972