The answer depends first on the size of the vein and second on issues of affordability. Generally, for veins that have a diameter greater than 5 or 6 mm’s, most Phlebologists believe that Laser is a better form of treatment. Sclerosant injection into veins of this size is challenging because the large amount of blood in these veins will dilute the sclerosant and make it difficult to get adequate concentrations of the sclerosant. This effect is not substantial for veins less than 4mm. Once veins are greater than 8mm the number of treatments that would be required generally make UGS an inefficient way of treating veins of this size.
ELA is however a more expensive procedure so the inconvenience of multiple visits may be preferable to the extra cost of ELA. Provided the veins are not over 8mm (which makes it extremely difficult to effectively close veins with UGS no matter how many treatments) after the initial occlusion is established the results are similar when patients are reviewed several years after treatment. However, the use of large quantities of sclerosant makes pigmentation more likely because of the large amount of blood that is trapped when very large veins are treated with UGS.