Cryolaser cryosclerotherapy versus isolated sclerotherapy for telangiectasias and reticular veins: A systematic review and meta-analysis.

In 30 seconds

This systematic review and meta-analysis compared adverse events after cryolaser cryosclerotherapy (CLaCS) and isolated sclerotherapy for lower-limb telangiectasias and reticular veins in adults with C1-C2 disease. Six studies involving 833 patients were included, with three contributing direct comparisons. CLaCS was associated with lower rates of telangiectatic matting (RR, 0.07 [95% confidence interval [CI], 0.01-0.36]), microthrombi (RR, 0.18 [95% CI, 0.06-0.54]), and ecchymosis (RR, 0.43 [95% CI, 0.32-0.58]). Hyperpigmentation and skin necrosis did not differ significantly between techniques.

Key findings

• Compared with isolated sclerotherapy, CLaCS was associated with less matting (RR, 0.07 [95% CI, 0.01-0.36]) and microthrombi (RR, 0.18 [95% CI, 0.06-0.54]).
• Ecchymosis was less frequent with CLaCS than isolated sclerotherapy (RR, 0.43 [95% CI, 0.32-0.58]).
• No significant between-technique difference was found for hyperpigmentation (RR, 0.29 [95% CI, 0.06-1.44]; I 2 = 92.1%) or skin necrosis (RR, 0.13 [95% CI, 0.02-1.00]).
• The pooled single-arm rate of satisfactory vessel clearance after CLaCS was 90.68% (95% CI, 76.74-98.87; I 2 = 94.6%) across five studies.

Why it matters

For treatment of lower-limb telangiectasias and reticular veins, adverse-event profiles may differ between CLaCS and isolated sclerotherapy. The comparative findings suggest lower rates of several complications with CLaCS, while the high heterogeneity for hyperpigmentation and vessel clearance underscores uncertainty in pooled estimates and the value of standardized outcome measurement.

What to keep in mind

Only six studies were included, and direct comparative data came from three. High heterogeneity was reported for hyperpigmentation and pooled vessel clearance; patient satisfaction could not be quantitatively synthesized because measurement instruments differed.