For foam sclerotherapy, duplex ultrasound is important in pre-treatment diagnosis, treatment monitoring/guidance, post-treatment efficacy evaluation and surveillance. In the pre-treatment diagnosis of varicose veins, the exact localisation of the insufficient saphenous, communicating and perforating veins is important. Duplex ultrasound is the accepted gold standard for this purpose. The application of ultrasound imaging during foam sclerotherapy increases the safety of accessing the vein in certain indications, and it can help when making a decision concerning the foam volumes to be injected, the patients' position or specific movements the patients should perform. Following treatment, the findings of duplex ultrasound, the clinical findings and the patients' symptoms can be arranged according to the recommended definitions. This allows grading of the therapeutic outcome and enables a better comparability between different treatment protocols or different treatments. Besides the evaluation of treatment success, duplex ultrasound is the method of choice to exclude or confirm complications such as deep venous thrombosis or disease progression.

This guideline represents the recent state of the art of sclerotherapy of varicose veins in Germany including foam sclerotherapy.

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