AbstractBackgroundWe performed this single‐centre prospective study, aimed to analyse the safety and efficacy of ultrasound‐guided foam sclerotherapy for primary isolated small saphenous vein (SSV) insufficiency.MethodsFrom June 2017 to June 2019, patients with primary SSV insufficiency and receiving ultrasound‐guided foam sclerotherapy were included in this study. The collected data included demographics of patients, clinical treatment results, occlusion rate and the patient's venous clinical severity score (VCSS) before and after surgery at 6‐month follow‐up.ResultsA total of 26 patients (14 women and 12 men) underwent ultrasound‐guided sclerotherapy in 26 lower limbs, and were followed up at 1 week, 1 month and 6 months after surgery. Short‐term complications included two severe pain during injection, one with vasovagal syncope, four with hyperpigmentation and two phlebitis. During 6‐month follow‐up, 22 were found to have complete thrombosis, and four showed partial thrombosis. There was a clear inverse relationship between SSV occlusion and SSV diameter (r = −0.502, P < 0.05), and pre‐operative VCSS evaluation (r = −0.598, P < 0.05). At the same time, there was a weak inverse relationship between SSV occlusion and the volume of foam used (r = −0.357, P < 0.05). The pre‐procedural VCSS score was 8.42 ± 3.25 and the post‐procedural VCSS score was 7.16 ± 3.14. Deep vein thrombosis, nerve injury and other important complications did not occur.ConclusionsThis study shows that ultrasound‐guided foam sclerotherapy is a safe and effective method for symptomatic SSV insufficiency, with less adverse reactions and better effects.