The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Ultrasound guided foam sclerotherapy for varicose veins in June 2006.

This document replaces previous guidance on Ultrasound-guided foam sclerotherapy for varicose veins (NICE interventional procedure guidance 314, August 2009).

NICE has published a clinical guideline on varicose veins in the legs (NICE guideline CG168, July 2013).


Small valves inside the veins help blood flow properly through them. Varicose veins develop when these valves do not work properly, allowing blood to collect in the veins. This enlarges them and causes the valves to deteriorate further. Varicose veins commonly occur in the legs. Many people have no symptoms, but if they do, these can include heaviness, aching, throbbing, itching, cramps or tiredness in the legs. In severe cases, patients may have skin discolouration or inflammation, or skin ulcers. Foam sclerotherapy involves mixing a chemical with air or another gas to produce a foam, which is injected into the affected vein using ultrasound imaging to monitor its progress. This causes scarring of the inside of the vein so that it becomes blocked. Sometimes patients may need more than 1 injection to block the vein.

Coding recommendations

L86.2 Ultrasound guided foam sclerotherapy for varicose vein of leg

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)