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Treatment of varicose veins has conventionally relied on  surgery for the implicated high recurrence rates with non surgical methods ,like older forms of visual  sclerotherapy (8-12). But follow up studies demonstrate that recurrent varicosities after surgery (REVAS) occur in almost 20-80% of patients at 5 to 20 years post surgery  (13). Almost 50% of patients  of  failed varicose vein surgery will require repeat surgery within five years. The rate of recurrence increases with the type of surgery, higher after high ligation. Surgical management has inherent complications and invasive techniques are often expensive. An audit of the surgeries done for varicosities revealed that there is an overall complication rate of 18% with commonly incurred nerve injuries in the range of 10-35%  (14-17).  Nerve  injury  post  stripping surgery  is  relatively  common  and could  give  permanent   loss of  sensation  in the site of  surgery  .

Cost benefit studies demonstrate that the new version of sclerotherapy, (Ultrasound  guided sclerotherapy ) could cost  twice that of older , visual sclerotherapy  but then it is only 10% of t