Obviously, very superficial veins do not need ultrasound guidance for access and foam can be injected after puncture and simple observation of blood reflux. Furthermore, very superficial veins are seen only with specific high frequency probes that are not always available. Anyway, controlling the passage of the foam into upper, bigger, and deeper veins is always useful. It is also necessary to remember that in veins smaller than 3 mm, foam has no advantage over liquid. Appropriate preliminary venous mapping is required in all cases of varicose vein treatment; post-treatment; ultrasound assessment of results after several days or weeks is also common practice for most phlebologists.
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