During ultrasound-guided sclerotherapy, duplex ultrasound technology is used to locate diseased veins that are hidden from view. Veins that cannot be seen with the ordinary eye can be visualized on an external monitor during ultrasound-guided sclerotherapy.

An experienced technician or treating surgeon maps out the veins to determine precisely which veins need injections and which veins are best left alone.

Using hi-resolution duplex ultrasound, doctors can determine how many injections are required. The chemical sclerosant solution is injected directly into the vein under direct vision and irritates the lining of the vein, causing the vein to close and shrink.
Eventually, the vein disappears altogether. It is largely a painless procedure, using a very small needle.

Ultrasound guided sclerotherapy is particularly advantageous for those who have already undergone varicose vein surgery once and have recurring veins. Using ultrasound, the doctor can pinpoint the exact cause of the recurring veins.

Treatment with ultrasound guided sclerotherapy helps to avert complications such as blood clots, leg ulcers, and dermatitis, in addition to relieving bothersome symptoms like aching, swelling, and tiredness. The success of treatment depends on how well backward flow points are controlled. It is also best for veins in areas that are too sensitive to laser or radio-frequency ablation, like the very low part of the leg close to the ankle.