Compression versus sclerotherapy for patients with isolated refluxing reticular veins and telangiectasia: a randomized trial comparing quality-of-life outcomes

Schul, Marlin; Eaton, Tam; Erdman, B E

doi:10.1258/phleb.2010.009092

Cited by 26 publications

(15 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A prospective randomised study that compared thigh-high compression stockings (20–30 mmHg) with sclerotherapy in patients with C1 CVD showed that compression therapy provides significant relief of aching (p < 0.0001), pain (p = 0.002), leg cramps (p = 0.003) and restlessness (p < 0.05), while sclerotherapy provides superior broad-spectrum symptom relief. 11 Furthermore, in two prospective randomised studies in patients with mild, moderate or severe CVD, Couzan et al. 12 , 13 compared progressive compression stockings (i.e.…”

Section: Recommendationsmentioning

confidence: 99%

Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement

et al. 2017

View full text Add to dashboard Cite

ObjectiveMedical compression stockings are a standard, non-invasive treatment option for all venous and lymphatic diseases. The aim of this consensus document is to provide up-to-date recommendations and evidence grading on the indications for treatment, based on evidence accumulated during the past decade, under the auspices of the International Compression Club.MethodsA systematic literature review was conducted and, using PRISMA guidelines, 51 relevant publications were selected for an evidence-based analysis of an initial 2407 unrefined results. Key search terms included: ‘acute', CEAP', ‘chronic', ‘compression stockings', ‘compression therapy', ‘lymph', ‘lymphatic disease', ‘vein' and ‘venous disease'. Evidence extracted from the publications was graded initially by the panel members individually and then refined at the consensus meeting.ResultsBased on the current evidence, 25 recommendations for chronic and acute venous disorders were made. Of these, 24 recommendations were graded as: Grade 1A (n = 4), 1B (n = 13), 1C (n = 2), 2B (n = 4) and 2C (n = 1). The panel members found moderately robust evidence for medical compression stockings in patients with venous symptoms and prevention and treatment of venous oedema. Robust evidence was found for prevention and treatment of venous leg ulcers. Recommendations for stocking-use after great saphenous vein interventions were limited to the first post-interventional week. No randomised clinical trials are available that document a prophylactic effect of medical compression stockings on the progression of chronic venous disease (CVD). In acute deep vein thrombosis, immediate compression is recommended to reduce pain and swelling. Despite conflicting results from a recent study to prevent post-thrombotic syndrome, medical compression stockings are still recommended. In thromboprophylaxis, the role of stockings in addition to anticoagulation is limited. For the maintenance phase of lymphoedema management, compression stockings are the most important intervention.ConclusionThe beneficial value of applying compression stockings in the treatment of venous and lymphatic disease is supported by this document, with 19/25 recommendations rated as Grade 1 evidence. For recommendations rated with Grade 2 level of evidence, further studies are needed.

show abstract

Section: Recommendationsmentioning

confidence: 99%

Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Venous symptoms adversely affecting QoL parameters may be more common than previously suspected and severity may not correlate to the size or type of refluxing veins. 44 The ideal treatment for varicose veins should be relatively noninvasive, repeatable if necessary, relatively safe, and free of significant complications. The fact that there has been no previous meta-analysis comparing surgery with other techniques for the treatment of varicose veins strictly in terms of QoL suggests that changes in QoL and symptomatic follow-up of these patients are much more difficult to measure than simple technical recurrence of the disease.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of various interventions versus standard stripping in patients with varicose veins in terms of quality of life

et al. 2017

View full text Add to dashboard Cite

Purpose Lower limb varicose veins have a significant effect upon the quality of life and a considerable socioeconomic impact despite their relatively benign nature. The aim of this study is to compare the effects of various therapeutic strategies among patients with varicose veins to surgical ligation and vein stripping on the basis of quality of life. Methods PubMed/Medline and Scopus databases were systemically searched from 1 January 2000 until 23 December 2015 for studies reporting outcome on the quality of life of different treatment techniques for varicose veins. We used Cohen's d to make the outcomes of the reported scales comparable. Heterogeneity was calculated with the use of the Q statistic and the I. Results A total of 1047 participants were randomized across all analyzed trials. The number of participants in a single trial ranged from 30 to 308. The majority of participants in any trial were C2 on the CEAP scores. Overall, the quality of evidence was low. For the meta-analysis performed at 12 months postintervention (seven studies, n = 1047 patients) and after random effects meta-analyses due to high heterogeneity, no differences are observed between intervention and surgical ligation and vein stripping. The pooled estimate is -0.001 and the 95% confidence interval is -0.069 to 0.067 with a p = 0.98. In the case of the 24 months, postintervention analysis (six studies, n = 840 patients) the inference is almost identical. The effect of various interventional modes of treatment compared to surgical ligation and vein stripping is negligible in terms of clinical outcomes and quality of life so that surgical ligation and vein stripping versus the other interventional procedures were equally effective approaches to treat great saphenous vein incompetence in terms of quality of life measurements. Conclusion The procedures were at least equally efficient in treating patients with varicose vein disease in terms of quality of life assessment tools at 12 and 24 months compared to surgical ligation and vein stripping.

show abstract

“…Evidence to support the use of ECS is also extrapolated from the CVI literature. Randomized trials comparing ECS to no intervention [106,107], low to high pressure ECS [108,109] and ECS to sclerotherapy [110] have demonstrated relief of symptoms with ECS. Guidelines also recommend ECS for CVI [111].…”

Section: Should Compression Therapies Be Used For Patients With Pts?mentioning

confidence: 99%

Prevention and Management of the Post-Thrombotic Syndrome

Makedonov

Kahn

Galanaud

2020

JCM

View full text Add to dashboard Cite

The post-thrombotic syndrome (PTS) is a form of chronic venous insufficiency secondary to prior deep vein thrombosis (DVT). It affects up to 50% of patients after proximal DVT. There is no effective treatment of established PTS and its management lies in its prevention after DVT. Optimal anticoagulation is key for PTS prevention. Among anticoagulants, low-molecular-weight heparins have anti-inflammatory properties, and have a particularly attractive profile. Elastic compression stockings (ECS) may be helpful for treating acute DVT symptoms but their benefits for PTS prevention are debated. Catheter-directed techniques reduce acute DVT symptoms and might reduce the risk of moderate–severe PTS in the long term in patients with ilio-femoral DVT at low risk of bleeding. Statins may decrease the risk of PTS, but current evidence is lacking. Treatment of PTS is based on the use of ECS and lifestyle measures such as leg elevation, weight loss and exercise. Venoactive medications may be helpful and research is ongoing. Interventional techniques to treat PTS should be reserved for highly selected patients with chronic iliac obstruction or greater saphenous vein reflux, but have not yet been assessed by robust clinical trials.

show abstract

Compression versus sclerotherapy for patients with isolated refluxing reticular veins and telangiectasia: a randomized trial comparing quality-of-life outcomes

Cited by 26 publications

References 18 publications

Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement

Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement

The effectiveness of various interventions versus standard stripping in patients with varicose veins in terms of quality of life

Prevention and Management of the Post-Thrombotic Syndrome

Contact Info

Product

Resources

About