Mini-invasive treatment of reticular varicose veins: sclerotherapy, micro-thermocoagulation, cyanoacrylate glue

Abstract

The aim — to compare the results of reticular varicose veins and telangiectasias treatment depending on used treatment method: sclerotherapy, micro­thermocoagulation or sclerotherapy with cyanoacrylate glue.Materials and methods. A prospective randomized controlled trial was undertaken in which 78 patients were enrolled. Most of them were females (72), aged 18 — 55 years. Patients were treated with sclerotherapy or micro­thermocoagulation, or sclerotherapy with cyanoacrylate adhesive. The results of the treatment were compared immediately after procedure, one month and 6 months after it.Results and discussion. The average length of the telangiectasias vascular network decreased more after micro­thermocoagulation (92.1 %), than after sclerotherapy (by 73.4 %), and adhesive injection (70.7 %) after procedure. The results achieved after the first method were statistically significantly different from two others (p < 0.01). In the group of patients who were treated with sclerotherapy, the total number of relapses during the period of observation was 8 (30.7 %), after micro­thermocoagulation — 7 (26.9 %) relapses, in case of cyanoacrylate injection — 8 (30.7 %) relapses. The difference between groups is not statistically significant (p = 0.941). In patients who underwent sclerotherapy, 15 (57.7 %) negative local effects were observed, among patients whom microthermocoagulation was performed — 11 (42.3 %) and in the group of patients whom adhesive was injected — 14 (53.8 %). The difference between the groups is not statistically significant (p = 0.518). Pain syndrome prevailed among the negative manifestations in all groups. Its intensity was mild, from 0 to 2. The least level of complains on the unpleasant feelings was in the group of patients who were treated with sclerotherapy, the highest — during micro­thermocoagulation. The difference between the groups is not statistically significant (p = 0.664). According to the quality of life questionnaire for chronic venous disease (CIVIQ 20), all three methods showed a statistically significant difference in the data before and one month after treatment (p < 0.001 for all groups).Conclusions. The studied methods of reticular varicose veins and telangiectasias treatment are quite safe for patients, the frequency of negative effects and minor local complications do not differ significantly in all groups (p = 0.518). Micro­thermocoagulation more effectively than injection methods eliminated telangiectasias, the average length of their vascular network decreased by 92.1 % (p < 0.01). It is easier to get obliteration of the reticular veins using sclerotherapy and cyanoacrylate glue injection than using micro­thermocoagulation with an uninsulated electrode. The number of relapses in a six­month period is not high, it was lowest after micro­thermocoagulation (26.9 %), but the difference was not statistically significant. Quality of life questionnaire for chronic venous disease showed a significant improvement in patients’ self­esteem in a month after treatment (p < 0.001 for all groups).