Ultrasound-guided sclerotherapy (UGS)

Ultrasound-guided sclerotherapy treats varicose veins that are hidden beneath the skin and not visible at the surface, including deeper feeder veins that supply visible varicose veins.

It is an alternative to vein surgery for medium-sized and advanced varicose veins, and can be performed in both summer and winter.

How it works

An ultrasound machine is used to visualise the hidden vein in real time. A sclerosant is then injected along the length of the vein under that ultrasound guidance, causing the varicose vein to collapse. Blood is redirected through healthier veins and the treated vein gradually fades.

UGS uses foam rather than liquid sclerosant. Foam has two practical advantages: less solution is required to achieve the result, and the foam adheres to the vessel wall and is visible under ultrasound, so the practitioner can see where the sclerosant is going and monitor the treatment as it is delivered.

This is what distinguishes UGS from standard sclerotherapy - the vein being treated cannot be seen with the naked eye, so imaging is what makes accurate targeting possible.

When UGS is used

Varicose veins that are not easily seen on the surface.
Deeper feeder veins connected to visible varicose veins.
Medium-sized and more advanced varicose veins.
As an alternative to surgery where a less invasive option is appropriate.

Me Clinic often prioritises ultrasound-guided sclerotherapy for more thorough and consistent treatment of varicose veins, because treating only what is visible at the surface tends to give a shorter-lived result when a deeper vein is the underlying source.

Assessment

Duplex ultrasound mapping is used to identify which veins are refluxing and to plan treatment before any injection is given. Recovery time and individual experience vary.

The treatment process

Consultation. A one-on-one consultation with a Me Clinic physician who assesses your condition, explains the treatment options and likely outcomes, gives an overview of the process and expected timeframes, undertakes a general medical consult in most cases, and provides a quote.
Booking. If you decide to proceed, a time is scheduled for your procedure.
The procedure. Your physician advises what to expect afterwards. When you can return home varies with the treatment performed.
Post-procedure. You may need to attend a check-up. The clinic is available for questions or concerns between appointments.

What to expect afterwards

You are provided with an after-hours direct number in case you have questions or concerns.

Normal and expected

Bruising. Some bruising is expected, and some patients bruise more easily than others. Arnica ointment - available from the clinic or any health food store - may be used as part of your aftercare.
Darkening. Some veins may turn dark soon after treatment and temporarily look worse before they look better.
Tenderness and redness along sections of the treated veins. This is not an infection. Walking rather than sitting may help manage soreness, though individual experiences vary. An oral anti-inflammatory is sometimes needed for quicker relief.
Lumps may form along sections of the treated veins. This is normal, and your doctor may treat them at a subsequent visit.

When to contact the clinic

Blisters over the skin. A dry dressing with a Melolin pad held with Micropore tape, changed daily, is usually all that is required.
Generalised rash or itching, particularly of the palms of the hands or soles of the feet. This most often indicates an allergic reaction - contact the clinic.

Activity after treatment

Walking up to 30 minutes daily while attending the clinic for treatment may be suggested, though individual experiences vary - discuss your activity with your doctor.
Vigorous exercise such as aerobics or running may need to be limited during recovery. Confirm with your doctor what applies to you.
Do not plan a long car or plane trip for a week after treatment.

Compression stockings

After treatment your legs may need to be taped or bandaged. You should then wear your stockings whenever standing, as advised by your doctor. Stockings may be removed when lying in bed, or temporarily when showering - on during the day, off at night.

They may need to be worn for a number of weeks after treatment. Your doctor will advise how long applies in your case.

Costs

As at September 2024 and including GST, an ultrasound-guided sclerotherapy treatment session starts from $740, and a vein consultation with a doctor - which may include ultrasound - is $230.

Treatment involving ultrasound monitoring generally costs more than standard sclerotherapy, which starts from $470, but both typically cost less than varicose vein surgery. Cost varies with the number of veins treated, the number of sessions required and the complexity of the treatment. See varicose vein treatment costs.

Is UGS covered by Medicare?

You may be able to claim a Medicare rebate for vein treatment. Your physician will discuss any applicable rebates at your initial consultation, and you can contact Medicare directly for further detail about what applies to your situation. A valid GP referral supports a claim.

Risks

All procedures carry some risk. Ultrasound-guided sclerotherapy does not generally require anaesthetic. Risks are discussed with you in detail at consultation, and you are given written information to take home. Please read our information on the risks and complications of cosmetic surgery before proceeding.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.

Who performs ultrasound-guided sclerotherapy

Dr Tim French (MED0001790529) is a phlebologist with AHPRA specialist and general registration and over a decade of clinical experience in venous medicine. He holds an MBBS, a Diploma of Surgical Anatomy (University of Melbourne), and further qualifications in phlebology and ultrasound in phlebology.

See sclerotherapy, varicose veins, endovenous laser ablation, or all vein treatments.