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In a  collaborative research Venous Research Foundation found  sustained  efficacy  of ultrasound guided foam sclerotherapy in the management of varicose veins. This technique (COMPASS technique) seems to have a distinct advantage over previously recommended stripping surgery.  Stripping surgery or the surgical removal of varicosities has  limitations due to the major trauma it causes and lack of aesthetic outcomes. As from its name , the “surgical stripper” (an knife like device) literally pulls / strips the veins through a skin incision ! ,  Painful !  , so it is only  done under anesthesia ??.  Yes , the  technique sounds quite medieval!  But guess what !  , that was the only technique once available to deal with varicose veins till recently ? . The long-term success rate for treatment of varicose veins by this traumatic technique is limited. The failure of stripping surgery to remove varicose veins completely, is obvious, for it is impossible to methodologically “ strip out ” hundreds of diseased networks of veins , distinctly from the normal veins, which are mostly unseen by the naked eye.  The surgeons knife fails, primarily due to its lack of accuracy in treating the  “hidden venous disease  ” under the skin. Thus, the success of surgery in varicose vein disease has been over stated over the years.

With the advent of Duplex ultrasound imaging techniques, detailed mapping of intricate networks of  “refluxing ” (diseased veins have reverse blood flow in them and is picked up on the ultrasound machine screen  , as a squirted red flow of blood .. reflux ! )