1 Guidance
1.1 Current evidence on ultrasound-guided foam sclerotherapy for varicose veins shows that it is efficacious in the short term. The evidence on safety indicates that there are transient side effects in a small number of patients such that the procedure should be used with special arrangements for consent, and for audit or research.
1.2 Clinicians wishing to undertake ultrasound-guided foam sclerotherapy for varicose veins should take the following actions. - Inform the clinical governance leads in their Trusts. - Patients should be fully informed of the potential side effects associated with the procedure. Clinicians should provide patients with clear written information. In addition, use of the Institute's 'Understanding NICE guidance' is recommended (available from www.nice.org.uk/IPG182publicinfo). - Audit and review clinical outcomes of all patients having ultrasound-guided foam sclerotherapy for varicose veins.
1.3 The procedure should only be undertaken using pharmaceuticals licensed for sclerotherapy of varicose veins. Current practice includes mixing liquid sclerosant with air with the intention of improving efficacy, and this constitutes off-label use.
1.4 Current evidence of long-term efficacy is limited and clinicians are encouraged to collect longer-term followup data.
1.5 The procedure has been referred to the Review Body for Interventional Procedures for a systematic review.