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In the last three decades sclerotherapy has evolved into a highly efficacious technique and offers a safe and economic therapeutic option in the management of large, medium and small or telangiectatic veins (3,19,20). Duplex ultrasound guided sclerotherapy is a major refinement in this technique (21-22). 

The key success of  Duplex ultrasound guided sclerotherapy technique remains in the ability of the physician in developing  a detailed  understanding  of the abnormal venous system . This is done by a technique called , "Venus Mapping ", which allows a very scientific way of treating only the deceased venous segments and allowing the body's ability to correct the venous circulation within remaining normal veins. Venous mapping traces the "origin of reflux" , "incompetent perforators", and  minimizes the chances of injection related complications, increases the precision of injection and decelerates disease progression by timely sequential treatments (21-24). Most importantly, Duplex ultrasound has helped to standardize the optimal dose and concentration of the sclerosant required to cause permanent sclerosis in a varicose vein . This is distinct from the mere thrombosis achieved by previous sclerotheapy techniques (8,9,16).

Randomized trials of sclerotherapy in the pre-ultrasound era have reported varied  success. The failure rate in these early