A Cochrane review [Abstract] 1 included 17 studies with a total of more than 3 300 subjects. One study (n=101) comparing sclerotherapy to graduated compression stockings (GCS) in pregnancy found that sclerotherapy improved symptoms and cosmetic appearance. Four studies (n=1831) compared sodium tetradecyl sulphate (STD) to alternative sclerosants: 3 studies 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. Two studies (n=622) 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 (n=102) 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. Sclerosant plus local anaesthetic reduced the pain from injection (one study) but had no other effects. There were no randomised trials comparing sclerotherapy to simple observation.
Comment: The quality of evidence is downgraded by limitations in study quality (inadequate or unclear blinding and allocation concealment) and by imprecise results (limited study size for each comparison).
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