Compression after sclerotherapy for telangiectasias and reticular leg veins: a randomized controlled study.
BACKGROUND
The efficacy of wearing compression stockings on clinical vessel disappearance following sclerotherapy of telangiectasias and reticular veins has been a matter of debate for half a century.


OBJECTIVE
To determine the relative efficacy of compression following sclerotherapy and to determine its impact on general quality of life in a prospective randomized open-label trial.


METHODS
Female patients seeking treatment of telangiectasias and reticular veins and presenting comparable areas of telangiectasias on the lateral aspect of the thigh (C1AorSEPAS1PN) were randomized to wear medical compression stockings (23 to 32 mm Hg) daily for 3 weeks or no such treatment following a single session of standardized liquid sclerotherapy. Outcome was assessed by patient satisfaction analysis and quantitative evaluation of photographs taken from the lateral aspect of the thigh before and again at 52 days on the average after sclerotherapy by two blinded expert reviewers. Patients completed a quality of life questionnaire (SF-36) before treatment and again at the control.


RESULTS
Data of 96 of 100 randomized patients could be evaluated. Patient satisfaction with the outcome of treatment was similar in the two groups. Objective assessment of clinical vessel disappearance revealed a benefit of wearing stockings (P=.026) corresponding to a NNT (number needed to treat) of 4.7 patients to get a vessel disappearance score higher than 6. The interobserver agreement was very high (intraclass correlation coefficient=0.93). Compression was well tolerated with a low rate of discomfort claims (mean 17.5%). Micro-thrombi were rarely observed in either group, but still less prevalent in the compression group. The rate of pigmentation and matting was low and did not differ significantly between the two groups. Physical and mental quality of life scores in women seeking treatment of telangiectasias were similar to those of a healthy control population. Treatment had no impact on general quality of life.


CONCLUSIONS
Wearing compression stockings (23 to 32 mm Hg) for 3 weeks enhance the efficacy of sclerotherapy of leg telangiectasias by improving clinical vessel disappearance.
Kern
Philippe
P
Department of Angiology, CHUV, Vevey, Switzerland. phkern@bluewin.ch
Ramelet
Albert-Adrien
AA
Wütschert
Robert
R
Hayoz
Daniel
D
D005260:Female; D006801:Humans; D007866:Leg; D015588:Observer Variation; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy; D012867:Skin / Q000098:blood supply*; D053828:Stockings, Compression; D011795:Surveys and Questionnaires; D013684:Telangiectasis / Q000473:pathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014680:Veins / Q000473:pathology
D012597:Sclerosing Solutions