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Injection sclerotherapy for varicose veins
Ricardo de Ávila Oliveira1, Rachel Riera2, Vladimir Vasconcelos3
1Surgery, Universidade Federal de Uberlândia, Uberlândia, Brazil.
The Cochrane Database of Systematic Reviews
|December 9, 2021
Summary
Injection sclerotherapy shows promise for treating varicose veins, potentially improving appearance and quality of life. However, evidence is limited, and deep vein thrombosis (DVT) risk may slightly increase.
Area of Science:
- Vascular Medicine
- Dermatology
- Medical Interventions
Background:
- Varicose veins affect up to one-third of the global population, potentially leading to chronic venous insufficiency.
- Injection sclerotherapy is a common treatment for varicose veins, aiming to close them off.
- Limited evidence exists on its effectiveness and safety, particularly for severe cases.
Purpose of the Study:
- To assess the effectiveness and safety of injection sclerotherapy for varicose veins.
- To update previous reviews with the latest randomized controlled trials (RCTs).
Main Methods:
- Systematic review and meta-analysis of RCTs comparing injection sclerotherapy to placebo, different concentrations, or liquid forms.
- Searched multiple databases including MEDLINE, Embase, and clinical trial registries up to July 2021.
- Assessed outcomes such as cosmetic appearance, complications (including DVT), residual veins, quality of life, and symptom persistence.
Main Results:
- Foam sclerotherapy may improve cosmetic appearance and reduce residual varicose veins compared to placebo, with a slight increase in DVT risk.
- Moderate certainty evidence suggests higher polidocanol foam concentrations may slightly decrease residual varicose veins.
- Limited evidence exists for foam vs. liquid sclerotherapy and comparisons between different sclerosing agents.
Conclusions:
- Injection sclerotherapy has very low to low-certainty evidence of effectiveness and safety for varicose veins compared to placebo.
- Further high-quality trials with standardized protocols are needed to increase evidence certainty.
- Deep vein thrombosis (DVT) rates may be slightly elevated, and data on recurrent varicose veins are scarce.
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