aree scientifiche

RESULTS:

Endovenous laser ablation and CHIVA were performed on 54 and 20 patients, respectively. The EVL patients had significantly higher pain scores and bruising than the CHIVA group (p<0.001). The VCSS of varicose, edema, pigmentation, and inflammation were significantly reduced after both EVL and CHIVA; however, patients treated by EVL had significantly more pain postoperatively than those treated by CHIVA (p=0.003). Twenty-two of 54 (40.7%) and 3 of 17 (17.6%) patients in the EVL and CHIVA groups, respectively, required sclerotherapy for residual varicosities (p=0.026). Both groups benefited significantly from surgery in disease-specific perceptions.

CONCLUSIONS:

The CHIVA patients had less pain postoperatively and a significantly higher sclerotherapy-free period compared to patients in the EVL group. Further follow-up studies to compare long-term results of various approaches to surgically managing varicose veins are needed.

10) DE FRANCISCIS S. et Al. : Hemodynamic surgery versus conventional surgery in chronic venous disease: a multicenter retrospective study. ACTA PHLEBOL. 2013; 14; 109-114

From 1994 to 2012, 11.026 patients were treated surgically, of which 6044 in CHIVA and 4982 in stripping. The average follow up was 9 years.

Compared to stripping, CHIVA seems to improve both clinical and hemodynamic results and reduce the number of recurrences.

11) ONIDA SARAH and ALUN H DAVIES

CHIVA, ASVAL and related techniques – Concepts and evidence

Phlebology 2015, Vol. 30(2S) 42–45

Abstract

Chronic venous disease (CVD) is a highly prevalent condition with significant effects on patients’ quality of life. Despite this, the underlying pathophysiology of venous disease still remains unclear. Two schools of

thought exist, explaining the development and propagation of venous disease as an ‘‘ascending’’ and ‘‘descending’’ process, respectively. The descending theory, stating that CVD is secondary to proximal disease (e.g. saphenofemoral/saphenous incompetence), is the most widely accepted when planning treatment aiming to remove or destroy the junction or truncal veins. The ascending theory, describing the disease process as developing in the lower most part of the leg and propagating cranially, aims to re-route the venous circulation via minimally invasive interventions. Classically, superficial venous insufficiency has been treated with the removal of the incompetent trunk, via open surgery or, increasingly, with endovenous interventions.Minimally invasive treatment modalities aiming to preserve the saphenous trunk, such as CHIVA and ASVAL, may alsoplay an important role in the treatment of the patient with varicose veins.

Keywords

ASVAL, chronic venous disease, chronic venous insufficiency, duplex ultrasound, haemodynamic surgery.

12) WANG H., CHEN Q., FEI Z., ZHENG E., YANG Z., HUANG X., HEMODYNAMIC CLASSICATION AND CHIVA TREATMENT OF VARICOSE VEINS IN LOWER EXTREMITIES(VVLE)

Int. J. Clin. Exp. Med., 2016, 9(2): pp. 2465–2471.

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