Axial Ablation Versus Terminal Interruption of the Reflux Source

Inclusion Criteria Primary or recurrent venous leg ulcer Long or short saphenous vein reflux confirmed on ultrasound assessment, defined as retrograde flow lasting for \>0.5 seconds Ankle-Brachial pressure Index (ABI) ≥ 0.8 (if ulceration prevents ABI Toe-Brachial Index(TBI) ≥ 0.5 acceptable), or a palpable pulse Ulcer size between 1 and 200 cm2 Patient suitable for full compression bandaging Exclusion criteria Pregnancy (or breastfeeding and needing to feed within 48 hours of treatment) Active infection of ulcer, or infection within the last two weeks Leg ulcer of non-venous aetiology as determined by clinical assessment Isolated perforator vein reflux only Evidence of deep venous insufficiency or thrombosis Known hypersensitivity to Sotradecol or similar sclerosants Previous inability to tolerate compression bandages Presence of any contraindications for the use of compression bandages: Absence of a palpable pulse, and Ankle Brachial Index (ABI) \<0.8 Decompensated congestive cardiac failure (NYHA Class IV) Known hypersensitivity to any of the component materials Patients unable to provide informed consent Patients attending the leg ulcer clinic already will be excluded from enrolment with the same ulcer but will be eligible to enrol with a contralateral ulcer. Recurrent ipsilateral ulcers will not be excluded.