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Doppler guided Sclerotherapy is comparable and in some instances superior to surgery in the treatment of GSV varicosities.  

Duplex-guided sclerotherapy or Echosclerotherapy is no longer an investigational technique. The precision in  detecting incompetent perforator veins  and origins of reflux with Duplex ultrasound has favored even the surgeons in using this technology in their pre and post surgical evaluations (27). Duplex-guided sclerotherapy is now the recommended treatment for recurrent varices after surgery (REVAS), as "redo" surgery is known to have high failure rates (28).

There are many studies which report superiority of this technique in achieving better clinical results. They estimate that more than 2,000 reported cases of major varicosities (> 7 mm) have been treated with this technique in both North America and Canada. These studies also demonstrate a significantly higher therapeutic response rates (80-90 % response at 2 years) , with no implicated life threatening complications (21,22,29-33). Reports from Europe with similar population demographics show that, this technique can achieve a sustained response comparable to or even superior to those achieved by major invasive surgeries (34-39).