French sclerotherapy and compression: Practice patterns

Abstract

Based on the recommendations of experts, and supported by a low level of proof, compression after sclerotherapy is applied all over the world. Objective: Investigating the practice of French vascular physicians for sclerotherapy and the use of post-sclerotherapy compression. Methods: A questionnaire concerning their practices was sent to French vascular physicians through their regional vascular medicine professional development associations. Results: A total of 366 vascular physicians replied to the questionnaire, of whom 63% (229/366) were in private practice, 6% (21/366) in hospitals and 31% (115/366) had a mixed private–hospital practice. Sclerotherapy was practised by 88% (323/366) of them. Two-thirds of the vascular physicians used sclerosing foam and practised sclerotherapy using ultrasound guidance. Less than one-third of the vascular physicians regularly applied compression after sclerotherapy. When compression was applied, it was usually after treatment of saphenous or accessory saphenous veins and, in most cases, medical compression stockings of 15–20 mm Hg were used. With respect to the period recommended for wearing compression, this ranged from 48 h to 1 week for 65% (193/299) of the vascular physicians questioned. Conclusion: The great majority of vascular physicians who answered the questionnaire employ ultrasound guidance to perform sclerotherapy and use sclerosing foam. Compression after sclerotherapy is diversely applied in France and does not comply with the recommendations of the French Health Authorities who recommend wearing a stocking of 15–20 or 20–36 mm Hg for a period of 4–6 weeks. Thus, less than one-third of the vascular physicians regularly used elastic compression and when they did, it was usually a medical compression stocking of 15–20 mm Hg, for 1 week or less.