CASE # 1  Undiagnosed venous reflux. Prior suboptimal sclerotherapy. 
 
 
Patient with several prior treatments (injections) for spider veins without permanent improvement. Prior treatments performed at a cosmetic center without evaluation of deep and superficial venous systems. Ultrasound revealed marked reflux in the right lower extremity and she underwent ablation of the greater saphenous vein with excellent results. Later on several sessions of sclerotherapy were performed for the residual spider and reticular veins.



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