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

Objective: To prospectively study quality-of-life (QoL) benefits comparing compression stockings to sclerotherapy in subjects with symptomatic reticular veins and telangiectasia.

Methods: Fifty-eight consecutive female patients with normal saphenous and deep venous systems and venous dysfunction score (VDS) ≥ 4 were randomized to either sclerotherapy (N = 29) or thigh high 20-30 mmHg compression stockings (N = 29). Following a trial of compression, subjects in the compression arm were eligible to crossover to the sclerotherapy arm. Patient-reported QoL data were acquired using a modified Aberdeen Varicose Vein Questionnaire in five stages, initial severity (T₀), following compression trial (T₁), after reticular vein sclerotherapy (T₂), approximately three months after sclerotherapy for telangiectasia (T₃) and the 12-month mark (T₄).

Result: For patients in the compression arm, four key symptoms including aching, pain, leg cramps and restlessness were significantly reduced, while patients in the sclerotherapy arm of treatment reported broad symptom relief in all key symptoms assessed.

Conclusion: Isolated refluxing reticular and telangiectatic vein disease may cause QoL impairment in select patients and represent far more than a cosmetic concern. Compression therapy offers relief of aching, pain, leg cramping and restlessness in patients with isolated refluxing reticular veins and telangiectasia. Sclerotherapy of reticular veins offers a statistically superior broad spectrum relief of symptoms, while additional sclerotherapy of residual telangiectasia in this cohort demonstrated additive relief of aching and pain. Symptom assessments at 12 months suggest ongoing symptom relief following sclerotherapy.