CCleaner has an option to clear 'Hotfix Uninstallers' in the Windows tab, Advanced sub-section. That however is a no way back if you happened to want to uninstall an MS KB Hotfix.
This isn't something I like to automate, so I too manually remove the old KB hotfixes after a month of no problems seen or reported about them. I also have hard disk imaging software, so my risk level is very low, not the same for everyone. Unfortunately to have such a backup and recovery strategy, you need space on the hard drive (lots of it).
Another area to look at is if windows manages the system restore size and or the Virtual memory size (paging file, a.k.a. pagefile.sys) which can be very large.