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Answer

What is the best outcome measure – proven occlusion of vein or patient satisfaction?

I think it is a bit of both.. both the vein’s correct occlusion and patient’s satisfaction are important and related to each other … long term satisfied patients come from correct treatment done..

Infected, and huge venous ulcer

I would prefer endovenous ablation of the GSV and SSV (with such large veins I would use a radial laser) and TRLOP of perforators – then 8 weeks or so later, foam sclerotherapy to sub-ulcer plexus. However, some might prefer the TIRS technique and use only foam – but such a large amount of reflux…

How would you treat intense recurrent varicose veins in the groin and close to the Femoral Vein?

Good question – I would use a thermal ablation to close as many connections with the femoral vein as possible (TRLOP / Hedgehog) or even HIFU – then foam more superficially anything that is left.

What sclerosant and concentration do you use to treat sub-ulcer stasis veins?

I am curious to see the feedback from other members as well.. Thank you

What sclerosant and concentration do you use to treat sub-ulcer stasis veins?

Well, usually I use STS (Fibrovein) foam, but I believe Aethoxysklerol foam can be used as well but in higher concentrations (2 -3 %)..