Recently, ultrasound-guided sclerotherapy has been introduced for the treatment of large varicose veins. The purpose of using an ultrasound in the treatment of varicose veins is for the visualization of the deeper source of pressure source of the bulging vein. Prior to ultrasound-guided therapy, the only treatment for large varicose veins was surgical stripping and ligation. Surgical removal of a bulging vein gives adequate results, however, complete resolution of the large vein occurs in slightly over 50% of the patients. Associated with surgical removal of these veins are side-effects such as scarring, hyperpigmented incision marks, bleeding and even nerve injury. Recent trends toward less surgery have fostered the ultrasound-guidance approach. Using the duplex ultrasound, a physician can visualize the origin of the vein and directly treat that source causing gradual shrinking of the vein.
Results at our office utilizing ultrasound-guidance have shown resolution of the large varicose veins in over 90% of the patients treated. The treatment protocol is, however, slightly more vigorous involving periodic ultrasound examinations over the course of the year during which treatment is scheduled. But once initiated, patients quickly become satisfied as the bulging varicose vein resolves and the symptoms disappear.