Haroun Gajraj: Polidocanol or STS – Choosing the Right Sclerosant
Haroun Gajraj, Phlebologist and Board Member of the British Association of Sclerotherapists, shared a post on LinkedIn:
“The Best Sclerosant for Leg Spider Veins: Polidocanol or STS?
Every phlebologist has this debate at some point.
Here’s my opinion: neither is proven to be categorically better.
The trial everyone points to (EASI) compared one specific polidocanol regimen against one specific STS regimen, not the drugs at equivalent strength.
Patients were more satisfied with the polidocanol arm, but that’s a regimen finding, not proof of superiority.
The older comparative studies don’t settle it either, and the lab data on platelets and clotting is useful mechanistic background, not a real-world complication-rate comparison between the two.
So how do you actually choose?
Patient comfort, prior individual response, and your own consistent technique are all important deciding factors, on the evidence we currently have.
What sclerosant do you use?
I look at the evidence and I spell it all out in my latest blog post …”
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