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Objective. The objective was to analyze the effectiveness of foam ultrasound-guided sclerotherapy treatment in saphenous veins and tributary veins with a diameter at the saphenofemoral or saphenopopliteal junction of ≥10 mm and compare these results with a subgroup of veins with diameters of < 10 mm.

Methods. A subgroup of 17 saphenous veins with a diameter at the saphenofemoral or saphenopopliteal junction of ≥10 mm were compared with a subgroup of 98 saphenous veins with a diameter of < 10 mm at the saphenofemoral or saphenopopliteal junction for clinical efficacy and patient satisfaction at a mean 2-year follow-up.

Results. A mean number of 2.15 treatments utilizing an average of 8.37 mL of foam sclerosing solution (3% sodium tetradecyl sulfate) were required to close all incompetent varicose veins in the < 10-mm group versus a mean of 2.8 treatments and 13.9 mL foam (3% sodium tetradecyl sulfate) for the ≥10-mm group. A total of 27.5% of saphenous veins of < 10 mm and 37.5% of saphenous veins ≥ 10 mm required a second treatment at 3 months. One-hundred percent of patients believed that their legs were successfully treated at 2-year follow-up in both groups with 94% of the < 10-mm group noting improvements in quality of life and 100% in the ≥10-mm group.

Conclusions. Ultrasound-guided foam sclerotherapy is effective in treating all sizes of varicose veins with high patient satisfaction and improvement in quality of life. Duplex ultrasound findings demonstrated a small increase in failure to close the saphenofemoral or saphenopopliteal junction with increasing size of junction diameter, but this does not significantly alter the results with respect to clearance of visible varicosities and patient satisfaction with results.