This technique closes the veins that cannot be visualized from the skin surface yet are causing the surface veins. Ultrasound is used to identify and target the veins so a strong sclerosing chemical can be injected.

• Less invasive (no surgery is required)
• Smaller veins that connect with the treated vein will often lighten or disappear
• Eventual sclerotherapy of smaller veins is enhanced

• Mild discomfort sometimes for several weeks
• Potential for skin staining just like regular sclerotherapy but is less frequent. (these usually fade but can be permanent)
• Trapped blood in sections between closed areas sometimes need to be drained with a small needle
• The story is not completely in about long term results but it appears that if the vein is not too large the results compare favorably with surgery
• Compression stocking must be worn for one week after the injections

It is best used when there is minimal surface involvement of larger veins and the surface problem is caused by deeper hidden veins. It is also an excellent way after EVLT (endovenous laser ablation therapy) to deal with any residual varicose veins. It is less than ideal for people with significant surface involvement with moderate to large varicose veins because of less desirable cosmetic outcomes, troublesome side effects from inflammation and less favorable long term results.

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