Literature DB >> 28973414

Sclerotherapy for Reticular Veins in the Lower Limbs: A Triple-Blind Randomized Clinical Trial.

Matheus Bertanha1, Rodrigo Gibin Jaldin1, Regina Moura1, Rafael Elias Farres Pimenta1, Jamil Victor de Oliveira Mariúba1, Carlos Eduardo Pinheiro Lúcio Filho1, Giovana Piteri Alcantara1, Carlos Roberto Padovani1, Winston Bonetti Yoshida1, Marcone Lima Sobreira1.   

Abstract

Importance: Reticular veins are subdermal veins located in the lower limbs and are mainly associated with aesthetic complaints. Although sclerotherapy is the treatment of choice for reticular veins in the lower limbs, no consensus has been reached regarding to the optimal sclerosant. Objective: To compare the efficacy and safety of 2 sclerosants used to treat reticular veins: 0.2% polidocanol diluted in 70% hypertonic glucose (HG) (group 1) vs 75% HG alone (group 2). Design, Setting, and Participants: Prospective, randomized, triple-blind, controlled, parallel-group clinical trial with patients randomly assigned in a 1:1 ratio between the 2 treatment groups from March through December 2014, with 2 months' follow-up. The study was conducted in a single academic medical center. Eligible participants were all women, aged 18 to 69 years, who had at least 1 reticular vein with a minimum length of 10 cm in 1 of their lower limbs. Interventions: The patients underwent sclerotherapy in a single intervention with either 0.2% polidocanol plus 70% HG or 75% HG alone to eliminate reticular veins. Main Outcomes and Measures: The primary efficacy end point was the disappearance of the reticular veins within 60 days after treatment with sclerotherapy. The reticular veins were measured on images obtained before treatment and after treatment using ImageJ software. Safety outcomes were analyzed immediately after treatment and 7 days and 60 days after treatment and included serious adverse events (eg, deep vein thrombosis and systemic complications) and minor adverse events (eg, pigmentation, edema, telangiectatic matting, and hematomas).
Results: Ninety-three women completed the study, median (interquartile range) age 43.0 (24.0-61.0) years for group 1 and 41.0 (27.0-62.0) years for group 2. Sclerotherapy with 0.2% polidocanol plus 70% HG was significantly more effective than with 75% HG alone in eliminating reticular veins from the treated area (95.17% vs 85.40%; P < .001). No serious adverse events occurred in either group. Pigmentation was the most common minor adverse event, with a 3.53% treated-vein pigmentation length for group 1 and 7.09% for group 2, with no significant difference between the groups (P = .09). Conclusions and Relevance: Sclerotherapy with 0.2% polidocanol diluted in 70% HG was superior to 75% HG alone in sclerosing reticular veins, with no statistical difference for complications. Pigmentation occurred in both groups, with no statistical difference between them. No serious adverse events occurred in either group. Trial Registration: clinicaltrials.gov Identifier: NCT02054325.

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Year:  2017        PMID: 28973414      PMCID: PMC5817453          DOI: 10.1001/jamadermatol.2017.3426

Source DB:  PubMed          Journal:  JAMA Dermatol        ISSN: 2168-6068            Impact factor:   10.282


  37 in total

Review 1.  Valves in small veins and venules.

Authors:  A Caggiati; M Phillips; A Lametschwandtner; C Allegra
Journal:  Eur J Vasc Endovasc Surg       Date:  2006-06-09       Impact factor: 7.069

Review 2.  Guidelines for the management of varicose veins.

Authors:  P Gloviczki; M L Gloviczki
Journal:  Phlebology       Date:  2012-03       Impact factor: 1.740

3.  Consensus for sclerotherapy.

Authors:  Margaret A Weiss; Jeffrey T S Hsu; Isaac Neuhaus; Neil S Sadick; David M Duffy
Journal:  Dermatol Surg       Date:  2014-12       Impact factor: 3.398

4.  Double-blind prospective comparative trial between foamed and liquid polidocanol and sodium tetradecyl sulfate in the treatment of varicose and telangiectatic leg veins.

Authors:  Jaggi Rao; John K Wildemore; Mitchel P Goldman
Journal:  Dermatol Surg       Date:  2005-06       Impact factor: 3.398

5.  Sclerotherapy of telangiectases and reticular veins: a double-blind, randomized, comparative clinical trial of polidocanol, sodium tetradecyl sulphate and isotonic saline (EASI study).

Authors:  E Rabe; D Schliephake; J Otto; F X Breu; F Pannier
Journal:  Phlebology       Date:  2010-06       Impact factor: 1.740

Review 6.  Myocardial infarction after ultrasoundguided foam sclerotherapy for varicose veins--a case report and review of the literature of a rare but serious adverse event.

Authors:  Rolf Peter Engelberger; Barbara Ney; Mathieu Clair; Amin Dabiri; Adriano Alatri; Lucia Mazzolai; Philippe Kern
Journal:  Vasa       Date:  2016       Impact factor: 1.961

Review 7.  Revision of the CEAP classification for chronic venous disorders: consensus statement.

Authors:  Bo Eklöf; Robert B Rutherford; John J Bergan; Patrick H Carpentier; Peter Gloviczki; Robert L Kistner; Mark H Meissner; Gregory L Moneta; Kenneth Myers; Frank T Padberg; Michel Perrin; C Vaughan Ruckley; Philip Coleridge Smith; Thomas W Wakefield
Journal:  J Vasc Surg       Date:  2004-12       Impact factor: 4.268

8.  [66% glucose, a safe sclerosant. Experimental study].

Authors:  A Bourgeois; J Quillard; J M Constantin; P Cottin; J P Cosson; A Le Baleur; I Bellagha; C Frileux
Journal:  J Mal Vasc       Date:  1984

9.  Epidemiology of chronic venous disease.

Authors:  L Robertson; C Evans; F G R Fowkes
Journal:  Phlebology       Date:  2008       Impact factor: 1.740

Review 10.  Cutaneous necrosis, telangiectatic matting, and hyperpigmentation following sclerotherapy. Etiology, prevention, and treatment.

Authors:  M P Goldman; N S Sadick; R A Weiss
Journal:  Dermatol Surg       Date:  1995-01       Impact factor: 3.398

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  1 in total

Review 1.  Treatment for telangiectasias and reticular veins.

Authors:  Luis Cu Nakano; Daniel G Cacione; Jose Cc Baptista-Silva; Ronald Lg Flumignan
Journal:  Cochrane Database Syst Rev       Date:  2021-10-12
  1 in total

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