Polidocanol Foam With or Without Transdermal Laser in Varicose Veins

Inclusion Criteria: * Age 21 to 75 years * CEAP clinical class 1-3 * Lower limb tributary varicose veins 2,5 to 4,0 mm in diameter on Doppler ultrasound. * Vein depth up to 4 mm from the skin surface. * Tributary vein may originate from the great or small saphenous vein as long as the saphenous vein is competent on Doppler. * Reflux limited to the target tributary. * Body mass index (BMI) \< 35 km²/m² * Able and willing to provide informed consent. Exclusion Criteria: * CEAP clinical class ≥ 4 * Axial reflux of the great or small saphenous vein requiring prior treatment * Tributary vein diameter \< 2.5 mm or \> 4.0 mm on Doppler * Tributary vein depth \> 4 mm from the skin surface * Pregnancy or breastfeeding * Known allergy or hypersensitivity to polidocanol * History of deep vein thrombosis or pulmonary embolism in the last 6 months * Use of anticoagulant therapy that cannot be safely interrupted * Active skin infection or ulcer at the treatment site * Autoimmune or connective tissue disease with active vasculitis * BMI ≥ 35 kg/m² * Inability to comply with follow-up visits * Previous treatment of the target vein in the past 6 months (laser, foam, surgery, or microphlebectomy).