Treatment for telangiectasias and reticular veins

Luis CU Nakano; Daniel G Cacione; Jose CC Baptista-Silva; Ronald LG Flumignan

doi:10.1002/14651858.CD012723.pub2

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Figure 1

Study flow diagram.

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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Analysis 1.1

Comparison 1: Sclerotherapy (any sclerosing agent) versus placebo, Outcome 1: Resolution or improvement of telangiectasias

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Analysis 1.2

Comparison 1: Sclerotherapy (any sclerosing agent) versus placebo, Outcome 2: Adverse events

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Analysis 1.3

Comparison 1: Sclerotherapy (any sclerosing agent) versus placebo, Outcome 3: Pain

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Analysis 2.1

Comparison 2: Sclerotherapy (polidocanol) versus sclerotherapy (any sclerosing agent), Outcome 1: Resolution or improvement of telangiectasias

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Analysis 2.2

Comparison 2: Sclerotherapy (polidocanol) versus sclerotherapy (any sclerosing agent), Outcome 2: Adverse events

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Analysis 2.3

Comparison 2: Sclerotherapy (polidocanol) versus sclerotherapy (any sclerosing agent), Outcome 3: Pain

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Analysis 3.1

Comparison 3: Sclerotherapy (STS) versus sclerotherapy (any sclerosing agent), Outcome 1: Resolution or improvement of telangiectasias

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Analysis 3.2

Comparison 3: Sclerotherapy (STS) versus sclerotherapy (any sclerosing agent), Outcome 2: Adverse events

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Analysis 3.3

Comparison 3: Sclerotherapy (STS) versus sclerotherapy (any sclerosing agent), Outcome 3: Pain

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Analysis 4.1

Comparison 4: Sclerotherapy (hypertonic saline) versus sclerotherapy (any sclerosing agent), Outcome 1: Resolution or improvement of telangiectasias

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Analysis 4.2

Comparison 4: Sclerotherapy (hypertonic saline) versus sclerotherapy (any sclerosing agent), Outcome 2: Adverse events

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Analysis 4.3

Comparison 4: Sclerotherapy (hypertonic saline) versus sclerotherapy (any sclerosing agent), Outcome 3: Pain

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Analysis 5.1

Comparison 5: Sclerotherapy (chromated glycerin) versus sclerotherapy (any sclerosing agent), Outcome 1: Resolution or improvement of telangiectasias

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Analysis 5.2

Comparison 5: Sclerotherapy (chromated glycerin) versus sclerotherapy (any sclerosing agent), Outcome 2: Adverse events

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Analysis 5.3

Comparison 5: Sclerotherapy (chromated glycerin) versus sclerotherapy (any sclerosing agent), Outcome 3: Pain

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Analysis 6.1

Comparison 6: Foam versus sclerotherapy (any sclerosing agent), Outcome 1: Resolution or improvement of telangiectasias

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Analysis 6.2

Comparison 6: Foam versus sclerotherapy (any sclerosing agent), Outcome 2: Adverse events

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Analysis 6.3

Comparison 6: Foam versus sclerotherapy (any sclerosing agent), Outcome 3: Pain

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Analysis 7.1

Comparison 7: Laser versus sclerotherapy (any sclerosing agent), Outcome 1: Resolution or improvement of telangiectasias

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Analysis 7.2

Comparison 7: Laser versus sclerotherapy (any sclerosing agent), Outcome 2: Adverse events

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Analysis 7.3

Comparison 7: Laser versus sclerotherapy (any sclerosing agent), Outcome 3: Pain

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Analysis 8.1

Comparison 8: Laser plus sclerotherapy (polidocanol) versus sclerotherapy (polidocanol), Outcome 1: Resolution or improvement of telangiectasias

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Analysis 8.2

Comparison 8: Laser plus sclerotherapy (polidocanol) versus sclerotherapy (polidocanol), Outcome 2: Adverse events

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Analysis 8.3

Comparison 8: Laser plus sclerotherapy (polidocanol) versus sclerotherapy (polidocanol), Outcome 3: Pain

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Analysis 9.1

Comparison 9: Sclerotherapy (polidocanol plus glucose) versus sclerotherapy (glucose), Outcome 1: Resolution or improvement of telangiectasias

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Analysis 9.2

Comparison 9: Sclerotherapy (polidocanol plus glucose) versus sclerotherapy (glucose), Outcome 2: Adverse events

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Analysis 9.3

Comparison 9: Sclerotherapy (polidocanol plus glucose) versus sclerotherapy (glucose), Outcome 3: Pain

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Analysis 10.1

Comparison 10: Sclerotherapy plus compression versus sclerotherapy alone, Outcome 1: Resolution or improvement of telangiectasias

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Analysis 10.2

Comparison 10: Sclerotherapy plus compression versus sclerotherapy alone, Outcome 2: Adverse events

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Analysis 10.3

Comparison 10: Sclerotherapy plus compression versus sclerotherapy alone, Outcome 3: Quality of life

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Summary of findings 1. Sclerotherapy compared to placebo for treatment of telangiectasias and reticular veins

Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants/procedures* (studies)	Certainty of the evidence (GRADE)	Comments
Sclerotherapy compared to placebo for treatment of telangiectasias and reticular veins
Patient or population: people with telangiectasias and reticular veins Setting: outpatient Intervention: sclerotherapy (any) Comparison: placebo
Outcomes	Risk with placebo	Risk with sclerotherapy	Relative effect (95% CI)	№ of participants/procedures* (studies)	Certainty of the evidence (GRADE)	Comments
Resolution or improvement of telangiectasias (follow‐up: 4 ‐ 12 weeks)		SMD 3.08 higher (2.68 higher to 3.48 higher)	‐	613 (4 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ hyperpigmentation (follow‐up: 4 ‐ 12 weeks)	Study population		RR 11.88 (4.54 to 31.09)	528 (3 RCTs)	⊕⊕⊕⊝ MODERATE^b	‐
	25 per 1000	299 per 1000 (114 to 784)	RR 11.88 (4.54 to 31.09)	528 (3 RCTs)	⊕⊕⊕⊝ MODERATE^b	‐
Adverse events ‐ matting (follow‐up: 4 ‐ 12 weeks)	Study population		RR 4.06 (1.28 to 12.84)	528 (3 RCTs)	⊕⊕⊕⊝ MODERATE^b	‐
Adverse events ‐ matting (follow‐up: 4 ‐ 12 weeks)	17 per 1000	68 per 1000 (22 to 216)	RR 4.06 (1.28 to 12.84)	528 (3 RCTs)	⊕⊕⊕⊝ MODERATE^b	‐
Pain (follow‐up: 1 day)		SMD 0.7 higher (0.06 higher to 1.34 higher)	‐	40 (1 RCT)	⊕⊕⊝⊝ LOW^c	‐
Recurrence	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Time to resolution	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Quality of life	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; SMD: standardised mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
^* Three studies used participants as the unit of analysis and one study used the number of procedures as the unit of analysis for each comparison. ^aWe downgraded by one level due to high clinical heterogeneity of the included studies. ^bWe downgraded by one level due to high clinical heterogeneity of the included studies and wide CI of the included studies (imprecision). ^c We downgraded by two levels due to high clinical heterogeneity of the included studies and only one included study with few participants.

Summary of findings 1. Sclerotherapy compared to placebo for treatment of telangiectasias and reticular veins

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Summary of findings 2. Sclerotherapy (polidocanol) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins

Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Sclerotherapy (polidocanol) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins
Patient or population: people with telangiectasias and reticular veins Setting: outpatient Intervention: sclerotherapy (polidocanol) Comparison: sclerotherapy (any sclerosant)
Outcomes	Risk with sclerotherapy (any sclerosant agent)	Risk with sclerotherapy (polidocanol)	Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Resolution or improvement of telangiectasias (follow‐up: 4 ‐ 16 weeks)		SMD 0.01 higher (0.13 lower to 0.14 higher)	‐	852 (7 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ hyperpigmentation (follow‐up: 4 ‐ 16 weeks)	Study population		RR 0.94 (0.62 to 1.43)	819 (6 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
	476 per 1000	447 per 1000 (295 to 680)	RR 0.94 (0.62 to 1.43)	819 (6 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ matting (follow‐up: 4 ‐ 16 weeks)	Study population		RR 0.82 (0.52 to 1.27)	859 (7 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ matting (follow‐up: 4 ‐ 16 weeks)	144 per 1000	118 per 1000 (75 to 183)	RR 0.82 (0.52 to 1.27)	859 (7 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Pain (follow‐up: 1 day)		SMD 0.26 lower (0.44 lower to 0.08 lower)	‐	480 (5 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Recurrence	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Time to resolution	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Quality of life	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; SMD: standardised mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
^* Three studies used participants as the unit of analysis and four studies used the number of procedures as the unit of analysis for each comparison. ^aWe downgraded by one level due to wide CIs.

Summary of findings 2. Sclerotherapy (polidocanol) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins

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Summary of findings 3. Sclerotherapy (STS) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins

Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Sclerotherapy (STS) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins
Patient or population: people with telangiectasias and reticular veins Setting: outpatient Intervention: sclerotherapy (STS) Comparison: sclerotherapy (any sclerosant)
Outcomes	Risk with sclerotherapy (any sclerosant)	Risk with sclerotherapy (STS)	Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Resolution or improvement of telangiectasias (follow‐up: 4 ‐ 16 weeks)		SMD 0.07 lower (0.25 lower to 0.11 higher)	‐	473 (4 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ hyperpigmentation (follow‐up: 4 ‐ 24 weeks)	Study population		RR 1.71 (1.10 to 2.64)	478 (4 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
	371 per 1000	634 per 1000 (408 to 979)	RR 1.71 (1.10 to 2.64)	478 (4 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ matting (follow‐up: 4 ‐ 24 weeks)	Study population		RR 2.10 (1.14 to 3.85)	323 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ matting (follow‐up: 4 ‐ 24 weeks)	82 per 1000	173 per 1000 (94 to 318)	RR 2.10 (1.14 to 3.85)	323 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Pain (follow‐up: 1 day)	Study population		RR 1.49 (0.99 to 2.25)	409 (4 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Pain (follow‐up: 1 day)	275 per 1000	410 per 1000 (273 to 619)	RR 1.49 (0.99 to 2.25)	409 (4 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Recurrence	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Time to resolution	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Quality of life	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; SMD: standardised mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
^* Two studies used participants as the unit of analysis and four studies used the number of procedures as the unit of analysis for each comparison. ^aWe downgraded by one level due to wide CIs and small number of participants.

Summary of findings 3. Sclerotherapy (STS) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins

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Summary of findings 4. Sclerotherapy (hypertonic saline) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins

Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Sclerotherapy (hypertonic saline) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins
Patient or population: people with telangiectasias and reticular veins Setting: outpatient Intervention: sclerotherapy (hypertonic saline) Comparison: sclerotherapy (any sclerosant)
Outcomes	Risk with sclerotherapy (any sclerosant)	Risk with sclerotherapy (hypertonic saline)	Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Resolution or improvement of telangiectasias (follow‐up: 4 ‐ 12 weeks)	‐	SMD 0.01 higher (0.2 lower to 0.22 higher)	‐	348 (3 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ hyperpigmentation (follow‐up: 8 ‐ 12 weeks)	Study population		RR 0.74 (0.59 to 0.93)	288 (2 RCTs)	⊕⊕⊕⊝ MODERATE^b	‐
	493 per 1000	365 per 1000 (291 to 459)	RR 0.74 (0.59 to 0.93)	288 (2 RCTs)	⊕⊕⊕⊝ MODERATE^b	‐
Adverse events ‐ matting (follow‐up: 8 ‐ 12 weeks)	Study population		RR 0.89 (0.58 to 1.36)	288 (2 RCTs)	⊕⊕⊕⊝ MODERATE^b	‐
Adverse events ‐ matting (follow‐up: 8 ‐ 12 weeks)	215 per 1000	192 per 1000 (125 to 293)	RR 0.89 (0.58 to 1.36)	288 (2 RCTs)	⊕⊕⊕⊝ MODERATE^b	‐
Pain (follow‐up: 1 day)	‐	SMD 6.22 higher (5.7 higher to 6.73 higher)	‐	348 (3 RCTs)	⊕⊕⊕⊝ MODERATE^c	‐
Recurrence	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Time to resolution	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Quality of life	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; SMD: standard mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
^* All studies used the number of procedures as the unit of analysis for each comparison. ^aWe downgraded by one level because of high risk of other bias in the included studies. ^bWe downgraded by one level because of wide CIs. ^cWe downgraded by one level because of clinical heterogeneity between included studies.

Summary of findings 4. Sclerotherapy (hypertonic saline) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins

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Summary of findings 5. Sclerotherapy (chromated glycerin) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins

Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Sclerotherapy (chromated glycerin) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins
Patient or population: people with telangiectasias and reticular veins Setting: outpatient Intervention: sclerotherapy (chromated glycerin) Comparison: sclerotherapy (any sclerosant)
Outcomes	Risk with sclerotherapy (any sclerosing agent)	Risk with sclerotherapy (chromated glycerin)	Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Resolution or improvement of telangiectasias (follow‐up: 5 ‐ 24 weeks)	‐	SMD 0.45 higher (0.11 lower to 1.02 higher)	‐	125 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
Adverse events ‐ hyperpigmentation (follow‐up: 5 ‐ 24 weeks)	Study population		RR 0.49 (0.09 to 2.50)	125 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
	66 per 1000	32 per 1000 (6 to 164)	RR 0.49 (0.09 to 2.50)	125 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
Adverse events ‐ matting (follow‐up: 5 ‐ 24 weeks)	Study population		RR 0.31 (0.01 to 7.53)	99 (1 RCT)	⊕⊕⊝⊝ LOW^a	‐
Adverse events ‐ matting (follow‐up: 5 ‐ 24 weeks)	21 per 1000	6 per 1000 (0 to 157)	RR 0.31 (0.01 to 7.53)	99 (1 RCT)	⊕⊕⊝⊝ LOW^a	‐
Pain (follow‐up: 1 day)	Study population		RR 1.50 (0.30 to 7.55)	26 (1 RCT)	⊕⊕⊝⊝ LOW^a	‐
Pain (follow‐up: 1 day)	154 per 1000	231 per 1000 (46 to 1000)	RR 1.50 (0.30 to 7.55)	26 (1 RCT)	⊕⊕⊝⊝ LOW^a	‐
Recurrence	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Time to resolution	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Quality of life	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; SMD: standardised mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
^* One study used participants as the unit of analysis and one study used the number of procedures as the unit of analysis for each comparison. ^a We downgraded by two levels due to few included studies and participants.

Summary of findings 5. Sclerotherapy (chromated glycerin) compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins

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Summary of findings 6. Foam compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins

Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Foam compared to sclerotherapy (any sclerosant) for telangiectasias and reticular veins
Patient or population: people with telangiectasias and reticular veins Setting: outpatient Intervention: foam Comparison: sclerotherapy (any sclerosant)
Outcomes	Risk with sclerotherapy (any sclerosing agent)	Risk with foam	Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Resolution or improvement of telangiectasias (follow‐up: 5 ‐ 10 weeks)	‐	SMD 0.04 higher (0.26 lower to 0.34 higher)	‐	187 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
Adverse events ‐ hyperpigmentation (follow‐up: 5 ‐ 10 weeks)	Study population		RR 2.12 (0.44 to 10.23)	187 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
	26 per 1000	55 per 1000 (11 to 265)	RR 2.12 (0.44 to 10.23)	187 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
Adverse events ‐ matting (follow up: 5 ‐ 10 weeks)	Study population		RR 6.12 (1.04 to 35.98)	187 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
Adverse events ‐ matting (follow up: 5 ‐ 10 weeks)	9 per 1000	53 per 1000 (9 to 310)	RR 6.12 (1.04 to 35.98)	187 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
Pain (follow up: 1 day)		SMD 0.1 lower (0.44 lower to 0.24 higher)	‐	147 (1 RCT)	⊕⊕⊝⊝ LOW^a	‐
Recurrence	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Time to resolution	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Quality of life	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; SMD: standardised mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
^* One study used participants as the unit of analysis and one study used the number of procedures as the unit of analysis for each comparison. ^aWe downgraded by two levels due to wide CIs and few participants in the included studies.

Summary of findings 6. Foam compared to sclerotherapy (any sclerosant) for treatment of telangiectasias and reticular veins

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Summary of findings 7. Laser compared to sclerotherapy for treatment of telangiectasias and reticular veins

Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Laser compared to sclerotherapy for treatment of telangiectasias and reticular veins
Patient or population: people with telangiectasias and reticular veins Setting: outpatient Intervention: laser Comparison: sclerotherapy
Outcomes	Risk with sclerotherapy	Risk with laser	Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Resolution or improvement of telangiectasias (follow‐up: 4 ‐ 24 weeks)	‐	SMD 0.09 lower (0.25 lower to 0.07 higher)	‐	593 (5 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ hyperpigmentation (follow‐up: 4 ‐ 24 weeks)	Study population		RR 0.57 (0.40 to 0.80)	262 (4 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
	328 per 1000	187 per 1000 (131 to 263)	RR 0.57 (0.40 to 0.80)	262 (4 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ matting (follow‐up: 16 ‐ 24 weeks)	Study population		RR 1.00 (0.46 to 2.19)	162 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ matting (follow‐up: 16 ‐ 24 weeks)	123 per 1000	123 per 1000 (57 to 270)	RR 1.00 (0.46 to 2.19)	162 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Pain (follow‐up: 1 day)	Study population		‐	100 (2 RCTs)	⊕⊝⊝⊝ LOW^b	We were not able to pool the data due to high heterogeneity
Pain (follow‐up: 1 day)	See comment	‐	‐	100 (2 RCTs)	⊕⊝⊝⊝ LOW^b	We were not able to pool the data due to high heterogeneity
Recurrence	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Time to resolution	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Quality of life	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; SMD: standardised mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
^* Two studies used participants as the unit of analysis and three studies used the number of procedures as the unit of analysis for each comparison ^aWe downgraded by one level due to wide CIs. ^bWe downgraded by two levels because of few included participants.

Summary of findings 7. Laser compared to sclerotherapy for treatment of telangiectasias and reticular veins

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Summary of findings 8. Laser plus sclerotherapy compared to sclerotherapy for treatment of telangiectasias and reticular veins

Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Laser plus sclerotherapy compared to sclerotherapy for treatment of telangiectasias and reticular veins
Patient or population: people with telangiectasias and reticular veins Setting: outpatient Intervention: laser plus sclerotherapy Comparison: sclerotherapy
Outcomes	Risk with sclerotherapy	Risk with laser plus sclerotherapy	Relative effect (95% CI)	№ of participants/procedures^* (studies)	Certainty of the evidence (GRADE)	Comments
Resolution or improvement of telangiectasias (follow‐up: 12 ‐ 16 weeks)	‐	SMD 5.68 higher (5.14 higher to 6.23 higher)	‐	710 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
Adverse events ‐ Hyperpigmentation (follow‐up: 12 ‐ 16 weeks)	Study population		RR 0.83 (0.35 to 1.99)	656 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
	64 per 1000	53 per 1000 (22 to 128)	RR 0.83 (0.35 to 1.99)	656 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
Adverse events ‐ matting (follow‐up: 12 ‐ 16 weeks)	Study population		RR 0.83 (0.21 to 3.28)	656 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
Adverse events ‐ matting (follow‐up: 12 ‐ 16 weeks)	18 per 1000	15 per 1000 (4 to 60)	RR 0.83 (0.21 to 3.28)	656 (2 RCTs)	⊕⊕⊝⊝ LOW^a	‐
Pain (follow‐up: 1 day)	Study population		RR 2.44 (1.69 to 3.55)	596 (1 RCT)	⊕⊕⊝⊝ LOW^b	‐
Pain (follow‐up: 1 day)	266 per 1000	649 per 1000 (449 to 944)	RR 2.44 (1.69 to 3.55)	596 (1 RCT)	⊕⊕⊝⊝ LOW^b	‐
Recurrence	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Time to resolution	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Quality of life	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; SMD: standardised mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
^* All studies used participants as the unit of analysis. ^aWe downgraded by two levels because of clinical heterogeneity in the included studies and the fact that the two studies were conducted by the same group of investigators. ^bWe downgraded by two levels due to having one included study.

Summary of findings 8. Laser plus sclerotherapy compared to sclerotherapy for treatment of telangiectasias and reticular veins

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Summary of findings 9. Sclerotherapy (hypertonic glucose plus polidocanol) compared to sclerotherapy (hypertonic glucose)

Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	No of Participants^* (studies)	Certainty of the evidence (GRADE)	Comments
Sclerotherapy (hypertonic glucose plus polidocanol) compared with sclerotherapy (hypertonic glucose) for telangiectasias and reticular veins
Patient or population: people with telangiectasias and reticular veins Settings: outpatient Intervention: sclerotherapy (hypertonic glucose plus POL) Comparison: sclerotherapy (hypertonic glucose)
Outcomes	Risk with hypertonic glucose	Risk with hypertonic glucose plus POL	Relative effect (95% CI)	No of Participants^* (studies)	Certainty of the evidence (GRADE)	Comments
Resolution or improvement of telangiectasias (follow‐up: 12 ‐ 16 weeks)	‐	SMD 0.79 higher (0.50 higher to 1.09 higher)		191 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ hyperpigmentation (follow‐up: 16 weeks)	Study population		RR 0.79 (0.62 to 1.01)	191 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
	649 per 1000	513 per 1000 (403 to 656)	RR 0.79 (0.62 to 1.01)	191 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ matting (follow‐up: 16 weeks)	Study population		RR 0.78 (0.51 to 1.20)	191 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ matting (follow‐up: 16 weeks)	351 per 1000	273 per 1000 (179 to 421)	RR 0.78 (0.51 to 1.20)	191 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Pain (follow‐up: 16 weeks)	Study population		RR 1.02 (0.83 to 1.24)	191 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Pain (follow‐up: 16 weeks)	443 per 1000	442 per 1000 (359 to 537)	RR 1.02 (0.83 to 1.24)	191 (2 RCTs)	⊕⊕⊕⊝ MODERATE^a	‐
Recurrence	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Time to resolution	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Quality of life	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; POL: polidocanol; RCT: randomised controlled trial; RR: risk ratio; SMD: standardised mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect
^* All studies used participants as the unit of analysis. ^aWe downgraded one level because of few participants in included studies.

Summary of findings 9. Sclerotherapy (hypertonic glucose plus polidocanol) compared to sclerotherapy (hypertonic glucose)

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Summary of findings 10. Sclerotherapy plus compression compared to sclerotherapy alone for telangiectasias and reticular veins

Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants (studies)^*	Certainty of the evidence (GRADE)	Comments
Sclerotherapy plus compression compared to sclerotherapy alone for telangiectasias and reticular veins
Patient or population: people with telangiectasias and reticular veins Setting: outpatient Intervention: sclerotherapy plus compression Comparison: sclerotherapy
Outcomes	Risk with sclerotherapy	Risk with sclerotherapy plus compression	Relative effect (95% CI)	№ of participants (studies)^*	Certainty of the evidence (GRADE)	Comments
Resolution or improvement of telangiectasias (follow‐up: 4 ‐ 8 weeks)	‐	SMD 0.09 higher (0.19 lower to 0.37 higher)	‐	196 (2 studies)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ hyperpigmentation (follow‐up:4 ‐ 8 weeks)	Study population		RR 0.93 (0.41 to 2.07)	196 (2 studies)	⊕⊕⊕⊝ MODERATE^a	‐
	112 per 1000	104 per 1000 (46 to 232)	RR 0.93 (0.41 to 2.07)	196 (2 studies)	⊕⊕⊕⊝ MODERATE^a	‐
Adverse events ‐ matting (follow‐up: 8 weeks)	Study population		RR 1.84 (0.17 to 19.62)	96 (1 study)	⊕⊕⊝⊝ LOW^b	‐
Adverse events ‐ matting (follow‐up: 8 weeks)	22 per 1000	40 per 1000 (4 to 427)	RR 1.84 (0.17 to 19.62)	96 (1 study)	⊕⊕⊝⊝ LOW^b	‐
Pain	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Recurrence	See comment	‐	‐	‐	‐	The studies in this comparison did not assess this outcome
Time to resolution	See comment		‐	‐	‐	The studies in this comparison did not assess this outcome
Quality of life (follow up: 8 weeks)		SMD 0.02 lower (0.42 lower to 0.39 higher)	‐	93 (1 study)	⊕⊕⊝⊝ LOW^b
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; SMD: standard mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect
^*All studies used participants as the unit of analysis. ^aWe downgraded one level because of few participants in included studies. ^bWe downgraded two levels because of few participants and only one included study.

Summary of findings 10. Sclerotherapy plus compression compared to sclerotherapy alone for telangiectasias and reticular veins

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Comparison 1. Sclerotherapy (any sclerosing agent) versus placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1.1 Resolution or improvement of telangiectasias Show forest plot	4	613	Std. Mean Difference (IV, Random, 95% CI)	3.08 [2.68, 3.48]

1.2 Adverse events Show forest plot	3		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

1.2.1 Hyperpigmentation	3	528	Risk Ratio (M‐H, Random, 95% CI)	11.88 [4.54, 31.09]
1.2.2 Matting	3	528	Risk Ratio (M‐H, Random, 95% CI)	4.06 [1.28, 12.84]
1.3 Pain Show forest plot	1		Std. Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 1. Sclerotherapy (any sclerosing agent) versus placebo

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Comparison 2. Sclerotherapy (polidocanol) versus sclerotherapy (any sclerosing agent)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
2.1 Resolution or improvement of telangiectasias Show forest plot	7	852	Std. Mean Difference (IV, Random, 95% CI)	0.01 [‐0.13, 0.14]

2.2 Adverse events Show forest plot	8		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

2.2.1 Hyperpigmentation	6	819	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.62, 1.43]
2.2.2 Matting	7	859	Risk Ratio (M‐H, Random, 95% CI)	0.82 [0.52, 1.27]
2.2.3 Bruising	4	558	Risk Ratio (M‐H, Random, 95% CI)	0.77 [0.56, 1.06]
2.2.4 Microthrombosis	4	394	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.69, 1.34]
2.2.5 Allergy	4	472	Risk Ratio (M‐H, Random, 95% CI)	0.68 [0.23, 2.01]
2.2.6 Necrosis	4	558	Risk Ratio (M‐H, Random, 95% CI)	0.07 [0.02, 0.29]
2.3 Pain Show forest plot	5	480	Std. Mean Difference (IV, Random, 95% CI)	‐0.26 [‐0.44, ‐0.08]

Comparison 2. Sclerotherapy (polidocanol) versus sclerotherapy (any sclerosing agent)

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Comparison 3. Sclerotherapy (STS) versus sclerotherapy (any sclerosing agent)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
3.1 Resolution or improvement of telangiectasias Show forest plot	4	473	Std. Mean Difference (IV, Random, 95% CI)	‐0.07 [‐0.25, 0.11]

3.2 Adverse events Show forest plot	5		Risk Ratio (IV, Random, 95% CI)	Subtotals only

3.2.1 Hyperpigmentation	4	478	Risk Ratio (IV, Random, 95% CI)	1.71 [1.10, 2.64]
3.2.2 Matting	2	323	Risk Ratio (IV, Random, 95% CI)	2.10 [1.14, 3.85]
3.2.3 Bruising	3	418	Risk Ratio (IV, Random, 95% CI)	1.62 [1.14, 2.30]
3.2.4 Microthrombosis	1	129	Risk Ratio (IV, Random, 95% CI)	1.04 [0.78, 1.39]
3.2.5 Allergy	3	452	Risk Ratio (IV, Random, 95% CI)	1.38 [1.01, 1.88]
3.2.6 Necrosis	2	392	Risk Ratio (IV, Random, 95% CI)	16.31 [3.14, 84.79]
3.3 Pain Show forest plot	4	409	Risk Ratio (M‐H, Random, 95% CI)	1.49 [0.99, 2.25]

Comparison 3. Sclerotherapy (STS) versus sclerotherapy (any sclerosing agent)

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Comparison 4. Sclerotherapy (hypertonic saline) versus sclerotherapy (any sclerosing agent)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
4.1 Resolution or improvement of telangiectasias Show forest plot	3	348	Std. Mean Difference (IV, Random, 95% CI)	0.01 [‐0.20, 0.22]

4.2 Adverse events Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

4.2.1 Hyperpigmentation	2	288	Risk Ratio (M‐H, Random, 95% CI)	0.74 [0.59, 0.93]
4.2.2 Matting	2	288	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.58, 1.36]
4.3 Pain Show forest plot	3	348	Std. Mean Difference (IV, Random, 95% CI)	6.22 [5.70, 6.73]

Comparison 4. Sclerotherapy (hypertonic saline) versus sclerotherapy (any sclerosing agent)

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Comparison 5. Sclerotherapy (chromated glycerin) versus sclerotherapy (any sclerosing agent)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
5.1 Resolution or improvement of telangiectasias Show forest plot	2	125	Std. Mean Difference (IV, Random, 95% CI)	0.45 [‐0.11, 1.02]

5.2 Adverse events Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

5.2.1 Hyperpigmentation	2	125	Risk Ratio (M‐H, Random, 95% CI)	0.49 [0.09, 2.50]
5.2.2 Matting	1	99	Risk Ratio (M‐H, Random, 95% CI)	0.31 [0.01, 7.53]
5.2.3 Bruising	1	26	Risk Ratio (M‐H, Random, 95% CI)	0.14 [0.02, 1.00]
5.2.4 Microthrombosis	1	99	Risk Ratio (M‐H, Random, 95% CI)	1.32 [0.45, 3.87]
5.3 Pain Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

Comparison 5. Sclerotherapy (chromated glycerin) versus sclerotherapy (any sclerosing agent)

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Comparison 6. Foam versus sclerotherapy (any sclerosing agent)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
6.1 Resolution or improvement of telangiectasias Show forest plot	2	187	Std. Mean Difference (IV, Random, 95% CI)	0.04 [‐0.26, 0.34]

6.2 Adverse events Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

6.2.1 Hyperpigmentation	2	187	Risk Ratio (M‐H, Random, 95% CI)	2.12 [0.44, 10.23]
6.2.2 Matting	2	187	Risk Ratio (M‐H, Random, 95% CI)	6.12 [1.04, 35.98]
6.2.3 Bruising	1	40	Risk Ratio (M‐H, Random, 95% CI)	0.60 [0.35, 1.04]
6.2.4 Microthrombosis	2	187	Risk Ratio (M‐H, Random, 95% CI)	1.39 [0.70, 2.76]
6.3 Pain Show forest plot	1		Std. Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 6. Foam versus sclerotherapy (any sclerosing agent)

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Comparison 7. Laser versus sclerotherapy (any sclerosing agent)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
7.1 Resolution or improvement of telangiectasias Show forest plot	5	593	Std. Mean Difference (IV, Random, 95% CI)	‐0.09 [‐0.25, 0.07]

7.2 Adverse events Show forest plot	4		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

7.2.1 Hyperpigmentation	4	262	Risk Ratio (M‐H, Random, 95% CI)	0.57 [0.40, 0.80]
7.2.2 Matting	2	162	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.46, 2.19]
7.2.3 Bruising	1	40	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.60, 1.04]
7.2.4 Necrosis	3	202	Risk Ratio (M‐H, Random, 95% CI)	1.60 [0.20, 12.74]
7.3 Pain Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

Comparison 7. Laser versus sclerotherapy (any sclerosing agent)

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Comparison 8. Laser plus sclerotherapy (polidocanol) versus sclerotherapy (polidocanol)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
8.1 Resolution or improvement of telangiectasias Show forest plot	2	710	Std. Mean Difference (IV, Random, 95% CI)	5.68 [5.14, 6.23]

8.2 Adverse events Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

8.2.1 Hyperpigmentation	2	656	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.35, 1.99]
8.2.2 Matting	2	656	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.21, 3.28]
8.3 Pain Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

Comparison 8. Laser plus sclerotherapy (polidocanol) versus sclerotherapy (polidocanol)

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Comparison 9. Sclerotherapy (polidocanol plus glucose) versus sclerotherapy (glucose)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
9.1 Resolution or improvement of telangiectasias Show forest plot	2	191	Std. Mean Difference (IV, Random, 95% CI)	0.79 [0.50, 1.09]

9.2 Adverse events Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

9.2.1 Hyperpigmentation	2	191	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.62, 1.01]
9.2.2 Matting	2	191	Risk Ratio (M‐H, Random, 95% CI)	0.78 [0.51, 1.20]
9.3 Pain Show forest plot	2	191	Risk Ratio (M‐H, Random, 95% CI)	1.02 [0.83, 1.24]

Comparison 9. Sclerotherapy (polidocanol plus glucose) versus sclerotherapy (glucose)

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Comparison 10. Sclerotherapy plus compression versus sclerotherapy alone

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
10.1 Resolution or improvement of telangiectasias Show forest plot	2	196	Std. Mean Difference (IV, Random, 95% CI)	0.09 [‐0.19, 0.37]

10.2 Adverse events Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

10.2.1 Hyperpigmentation	2	196	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.41, 2.07]
10.2.2 Matting	1	96	Risk Ratio (M‐H, Random, 95% CI)	1.84 [0.17, 19.62]
10.3 Quality of life Show forest plot	1		Std. Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 10. Sclerotherapy plus compression versus sclerotherapy alone

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