Ultrasound-guided foam sclerotherapy within a rolling treatment programme is an effective low-cost treatment for superficial venous insufficiency.

Aims To review the results and cost of a rolling ultrasound-guided foam sclerotherapy (UGFS) treatment programme for patients with chronic superficial venous insufficiency. Method A prospective study of a rolling treatment programme where patients were offered unlimited follow-up at intervals of 6-8 weeks and further (top up) UGFS when necessary, until occlusion criteria were met. Results A total of 213 lower limbs with complete follow-up were included in the study. Median (range) age was 57 (16-94) years, maximum diameter of varicose vein was 10 (3-18) mm, C of CEAP (clinical, aetiological, anatomical and pathological elements) was 4 (2-6), number of treatment sessions was one (1-4) and follow-up was three (1.5-33) months. Satisfactory occlusion could not be achieved in nine (4%) limbs. The ratio of odds (95% CI) for requiring more than one treatment session was 3.58 (1.46-8.77), P = 0.002 for great saphenous varicosity and 2.11 (1.13-3.94), P = 0.015 for age 50 or more. There were 20 (9.3%) immediate and 63 (29.5%) delayed adverse effects. All were minor except for one cutaneous nerve injury, one pulmonary embolism and one infected haematoma. The ratio for odds (95% CI) for post-treatment skin discolouration was 2.59 (1.14-5.87), P = 0.017 for women and 1.32 (1.02-1.71), P = 0.032 for increasing sclerosant volume used. Service line costing per completed treatment episode was 115.22 (Euro130.07, $188.60). Conclusion UGFS in a rolling treatment programme is safe and can achieve high occlusion rates at a low cost. Patients above the age of 50 with great saphenous varicosity are likely to require more than one treatment session.