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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.

Comment in

Video-guided CHIVA treatment. [Dermatol Surg. 1995]

WEISS RA : Video-guided CHIVA treatment.

Dermatol Surg. 1995 Jul;21(7):626.

Comment on: When CHIVA treatment could be video guided. [Dermatol Surg. 1995

7) ZAMBONI P. et AL.: Angiovideo-assisted hemodynamic correction of varicose veins.

Int Angiol. 1995 Jun;14(2):202-8.

Abstract

OBJECTIVE:

Evaluation of the feasibility and utility of angioscopy in the hemodynamic correction (French acronyms is CHIVA) of primary varicose veins disease.

EXPERIMENTAL DESIGN:

Prospective evaluation of 25 patients, undergoing hemodynamic correction of primary varicose disease with intraoperative videoangioscopic guide. Patients have been selected according to criteria emerged from a prospective study that we had previously conducted. Follow-up lasted 1 year (range 8-18 months).

SETTING:

Department of Surgery, University of Ferrara, Italy. Institutional practice. One-day surgery.

PATIENTS:

Their selection has been carried out in our Vascular Laboratory. The adopted clinical criteria of selection were: Primary varicose disease of the long saphenous vein territory, no previous thrombophlebitis and/or sclerotherapy. Doppler cw and Duplex criteria followed were: competent deep venous system, long saphenous vein diameter minor than 10 mm and incompetent perforating veins diameter minor than 4 mm.

INTERVENTIONS:

25 hemodynamic corrections according to the CHIVA method described by Franceschi. An angioscope, introduced through a distal collateral of the long saphenous vein, permitted the precise interruption of the venous-venous shunts and of the superficial venous system, just below the perforators chosen as re-entry points in the deep venous system.

MEASURES:

Clinical: varices and symptomatology reduction. Duplex and Doppler cw: detection of the superficial blood flow re-entry, in the deep venous system, through the perforators and identification of recurrences or new refluxes. Pre and postoperative Ambulatory Venous Pressure and Refilling Time have also been measured.

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