Foam sclerotherapy compared with liquid sclerotherapy for the treatment of lower extremity varicose veins

Abstract

Background: There is a continued discussion on which is the best sclerosant to treat lower extremity varicose veins. Therefore, we did this meta-analysis to determine that foam sclerotherapy versus liquid sclerotherapy, which could perform better in the treatment of lower extremity varicose veins. Materials and methods: We independently searched 5 databases from inception to February 1, 2019, for randomized controlled trials and prospective controlled trials for comparing foam sclerotherapy and liquid sclerotherapy for the treatment of lower extremity varicose veins. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of studies. The primary outcome and secondary outcomes were analyzed using stata 15.0. This meta-analysis was performed according to Cochrane Handbook. Results: There were significant differences in effective rate (P < .001, odd ratios = 5.64, 95% confidence interval = 3.93–8.10) and incidence rate of pain (P = .030, odd ratios = 1.52, 95% confidence interval = 1.04–2.21) between foam sclerotherapy and liquid sclerotherapy. And there were no significant differences among local inflammation (P = .896, rate difference = 0.00, 95% confidence interval = –0.03 to 0.03), thrombophlebitis (P = .90, rate difference = 0.00, 95% confidence interval = −0.02 to 0.02) and hyperpigmentation (P = .336, rate difference = 0.05, 95% confidence interval = −0.05 to 0.14). Conclusions: Although foam sclerotherapy has a higher incidence rate of complications, it could achieve a more stable clinical efficacy in the treatment of lower extremity varicose veins than liquid sclerotherapy.

Management of Lower Extremity Pain from Chronic Venous Insufficiency: A Comprehensive Review

“…In recent years, several clinical trials have demonstrated decreased efficacy of liquid sclerotherapy when compared to foam for treatment of saphenous vein varicosities. A meta-analysis and a systematic review both demonstrated increased efficacy when evaluating ultrasound-demonstrated elimination of reflux [ 220 , 221 ].…”

“…However, another trial measuring outcomes at 3 months determined that although mean changes in CIVIQ scores were comparable between groups, patient and physician satisfaction with foam sclerotherapy was significantly higher [ 225 ]. Liquid therapy was noted to have overall similar or perhaps fewer complications, although both therapies were determined to be generally safe [ 221 , 226 – 228 ]. Adverse events in liquid sclerotherapy were similar to those of foam sclerotherapy.…”

Sclerotherapy contraindications, sequelaes, and complications – informing patients properly and objectively is required

“…Because sclerotherapy is divided into 2 major kinds -liquid and foam -there are different risks of side effects [3,18,[19][20][21][22]. Foam sclerotherapy has a relatively high percentage of complications, but it can achieve higher stability of clinical effectiveness in treating varicose veins of lower limbs than liquid sclerotherapy [3,11,19,20]. Several sclerotherapy adverse effects have been reported, and the procedure complications can be divided into common, uncommon, or rare (Table 1, 2).…”

Hiperpigmentación postesclerosis química o fotónica. Estudio clínico retrospectivo y revisión de la literatura

“…El daño endotelial ocurre de forma rápida, a los pocos minutos de su administración, y puede extenderse hacia las capas media y adventicia en virtud de la concentración del esclerosante empleado que, a su vez, es determinante en la aparición de HPE [1, 5,10]. Es recomendable ajustar la concentración al diámetro del vaso a tratar, aunque no hay diferencias significativas en cuanto a HPE entre la utilización de esclerosante líquido o en forma de MPOL [11,12]. La glicerina cromada es el representante de los denominados esclerosantes irritantes.…”