Sclerotherapy for lower limb telangiectasias

Sclerotherapy (with sodium tetradecyl sulfate, polidocanol or heparsal) may be more effective than placebo in the treatment of telangiectasias of the lower limbs.

The quality of evidence is downgraded by study limitations (unclear allocation concealment), and by imprecise results (few patients and outcome events).

Summary

A Cochrane review included 10 studies with a total of 484 subjects evaluating a number of sclerosing agents used in the treatment of telangiectasias of the lower limbs. The data were not suitable for meta-analysis. There was no evidence suggesting superior efficacy of any one sclerosant over another, but there was evidence of superiority of sclerotherapy to placebo; statistically significant evidence from the included trials suggests that sodium tetradecyl sulfate (STS), polidocanol (POL) and heparsal have higher efficacy than a normal saline placebo. The evidence did not suggest an increase in patient satisfaction with any one agent versus another, but there was evidence that patients were less satisfied with placebo. There was some evidence suggesting that POL was more likely to cause adverse reactions at a concentration of 1% compared with lower concentrations or hypertonic saline, and that STS was more likely to cause adverse reactions at a concentration of 1% compared with POL at 0.5%. There was some evidence suggesting that STS was more painful than POL, heparsal (20% saline mixed with heparin 100 units/mL) or placebo, and that POL was no more painful than placebo. Evidence from one study suggested that hypertonic saline (HS) was more painful than POL.

Clinical comments

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Ədəbiyyat

1. Schwartz L, Maxwell H. Sclerotherapy for lower limb telangiectasias. Cochrane Database Syst Rev 2011;12:CD008826.