When CHIVA treatment could be video guided.
BACKGROUND
Hemodynamic correction (CHIVA) is a conservative, ambulatory, and controversial varicose vein treatment. It consists of selected ligatures of the superficial venous system decided by means of preoperative duplex mapping.


OBJECTIVE
Prospective evaluation of 80 patients, operated on according to the CHIVA technique described by Claude Franceschi. Mean follow-up length was 30 months.


METHODS
Fifty-five consecutive patients were operated on after clinical, ultrasonographic, ambulatory venous pressure and light reflection rheography evaluations. After a 3-year follow-up, another 25 consecutive patients were selected applying some exclusion criteria that emerged in the first part of the study. This second series was operated on by means of intraoperative angioscopy. The same preoperative evaluations have been used to study the outcome in all patients.


RESULTS
CHIVA failed in the short saphenous vein territory varices and when the long saphenous vein and the insufficient perforating veins had a preoperative diameter greater than 10 and 4 mm, respectively. The procedure showed a long saphenous vein patency of 90.4% and registered a total recurrence rate of 18.7%.


CONCLUSIONS
CHIVA seems to be a more effective varicose vein treatment than high ligation and distal stab avulsion. It also preserves a higher rate of long saphenous veins, suitable for bypass surgery.
Zamboni
P
P
Institute of General Surgery and Vascular Laboratory, University of Ferrara, Italy.
Marcellino
M G
MG
Feo
C
C
Berta
R
R
Vasquez
G
G
Pansini
G C
GC
D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures; D017546:Angioscopy; D003097:Collateral Circulation; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D018056:Hemorheology; D006801:Humans; D007430:Intraoperative Care; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015642:Radiology, Interventional; D012008:Recurrence; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery; D014172:Transillumination; D016896:Treatment Outcome; D014463:Ultrasonography; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D014654:Vascular Patency; D014690:Venous Pressure