Clinical outcome of short-term compression after sclerotherapy for telangiectatic varicose veins

J Vasc Surg Venous Lymphat Disord. 2021 Mar;9(2):435-443. doi: 10.1016/j.jvsv.2020.05.015. Epub 2020 Jun 2.

Abstract

Background: Sclerotherapy is considered to be the method of choice for the treatment of telangiectatic varicose veins (C1 veins). Whereas the use of compression stockings after sclerotherapy is recommended, little is known about the impact of compression on the outcome of sclerotherapy. The aim of this study was to assess the influence of compression on the outcome of injection sclerotherapy of C1 varicose veins.

Methods: There were 100 legs of 50 consecutive patients with chronic venous insufficiency (C1) included. After randomization per patient, both legs were treated with sclerotherapy in a predefined area of the thigh (measuring 100 cm2), followed by eccentric compression for 24 hours. Group A received no further compression, whereas group B was additionally equipped with compression stockings of 18 to 20 mm Hg above the ankle and continued wearing these for 1 week. Photodocumentation was performed before, 1 week after, and 4 weeks after sclerotherapy, and the clinical outcome was assessed at these postprocedure follow-up dates. The photographs were reviewed by an internal unblinded rater and an independent blinded external rater.

Results: There was no discernible difference between the groups in terms of clinical outcome or side effects after 4 weeks. Whereas inter-rater reliability was high, there was no correlation between the raters and patients in terms of outcome. In 55% of the treated legs, the patients deemed the result of the treatment to be good; in 27% of the treated legs, fair; and in 18%, poor. Postprocedure hyperpigmentation occurred in 13% of patients and was comparable in both groups. Compression therapy was found to be comfortable by the majority (58%) of patients.

Conclusions: One week of postinterventional compression therapy had no clinical benefit compared with no compression.

Keywords: Ompression therapy; Sclerotherapy; Telangiectatic veins.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Chronic Disease
  • Combined Modality Therapy
  • Germany
  • Humans
  • Injections, Intravenous
  • Polidocanol / administration & dosage*
  • Polidocanol / adverse effects
  • Prospective Studies
  • Sclerosing Solutions / administration & dosage*
  • Sclerosing Solutions / adverse effects
  • Sclerotherapy* / adverse effects
  • Stockings, Compression* / adverse effects
  • Telangiectasis / diagnostic imaging
  • Telangiectasis / physiopathology
  • Telangiectasis / therapy*
  • Time Factors
  • Treatment Outcome
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / physiopathology
  • Varicose Veins / therapy*
  • Venous Insufficiency / diagnostic imaging
  • Venous Insufficiency / physiopathology
  • Venous Insufficiency / therapy*

Substances

  • Sclerosing Solutions
  • Polidocanol