Duplex ultrasound outcomes following ultrasound-guided foam sclerotherapy of symptomatic recurrent great saphenous varicose veins

Eur J Vasc Endovasc Surg. 2011 Jul;42(1):107-14. doi: 10.1016/j.ejvs.2011.03.010. Epub 2011 Apr 6.


Objectives: To describe duplex ultrasound (DUS) outcomes 12 months following ultrasound-guided foam sclerotherapy (UGFS) of recurrent great saphenous varicose veins (GSVV).

Methods: A consecutive series of UK National Health Service patients underwent serial DUS examinations following UGFS with 3% sodium tetradecyl sulphate for symptomatic recurrent GSVV.

Results: 91 treated legs (CEAP C(2/3) 58, C(4) 21, C(5) 8, C(6) 4) belonging to 73 patients (24 male) of median age 58 (range 32-86) years were enrolled between November 2004 and May 2007. The median volume of foam used was 8 (range 4-14) ml. Above-knee (AK) and below-knee (BK) GSV reflux was present in 88 (97%) and 80 (88%) legs respectively prior to treatment. AK and BK-GSV reflux was completely eradicated by a single session of UGFS in 86 (98%) and 74 (93%) legs respectively; and by two sessions of UGFS in 88 (100%) and 77 (97%) legs respectively. In those legs where GSV reflux had been eradicated, recanalisation occurred in 7/78 (9%) AK and 8/68 (12%) BK-GSV segments after 12 months follow-up. Retreatment, where undertaken, with a single UGFS session effectively eradicated all GSV reflux in all cases of recanalisation.

Discussion: A single session of UGFS can eradicate reflux in the AK and BK-GSV in over 93% of patients with symptomatic recurrent GSVV. Re-recurrence at 12 months is superior to that reported after redo GSV surgery, similar to that observed following other minimally-invasive techniques and, when it occurs, is effectively and simply treated by a single further session of UGFS.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • England
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Retreatment
  • Saphenous Vein / diagnostic imaging*
  • Sclerosing Solutions / therapeutic use*
  • Sclerotherapy / methods*
  • Sodium Tetradecyl Sulfate / therapeutic use*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex*
  • Ultrasonography, Interventional*
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / therapy*


  • Sclerosing Solutions
  • Sodium Tetradecyl Sulfate