Varicose vein stripping vs haemodynamic correction (CHIVA): a long term randomised trial.
OBJECTIVE
To compare the long-term results of stripping vs. haemodynamic correction (Ambulatory Conservative Haemodynamic Management of Varicose Veins, CHIVA) in the treatment of superficial venous incompetence resulting in chronic venous disease (CVD).


METHODS
Randomised comparative trial.


METHODS
150 patients affected by CVD, CEAP clinical class 2-6, were randomised to saphenous stripping or to CHIVA.


METHODS
The clinical outcome was assessed by an independent observer who recorded the Hobbs clinical score for treated limbs. A subjective report of the outcome was provided by the patients. Recurrence of varices was assessed by both clinical examination and duplex ultrasonography.


RESULTS
The mean follow-up was 10 years, 26 patients were lost to follow-up. The Hobbs score similar in the stripping and CHIVA groups. However recurrence of varicose veins was significantly higher in the stripping group (CHIVA 18%; stripping 35%, P<0.04 Fisher's exact test), without significant differences in the rate of recurrences from the sapheno-femoral junction. The associated risk of recurrence at ten years was doubled in the stripping group (OR 2.2, 95% CI 1-5, P=0.04).


CONCLUSIONS
Recurrent varices occurred more frequently following saphenous stripping than after CHIVA treatment. The deliberate preservation of the saphenous trunk as a route of venous drainage in the CHIVA group may have been a factor reducing the recurrence rate.
Carandina
S
S
Department of Surgical, Anaesthesiological, and Radiological Sciences, Day-Surgery Unit, Vascular Diseases Center, University of Ferrara, Italy.
Mari
C
C
De Palma
M
M
Marcellino
M G
MG
Cisno
C
C
Legnaro
A
A
Liboni
A
A
Zamboni
P
P
D002908:Chronic Disease; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017060:Patient Satisfaction; D018570:Risk Assessment; D055502:Secondary Prevention; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014656:Vascular Surgical Procedures; D014689:Venous Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery