WHEN CHIVA TREATMENT COULD BE VIDEO GUIDED

BACKGROUND. Hemodynamic correction (CHIVA) is a conservative, ambulato ry, and controversial varicose vein treatment. It consists of selected ligatures of the superficial venous system, decided by means of preop erative duplex mapping. OBJECTIVE. Prospective evaluation of 80 patien ts, operated on according to the CHIVA technique described by Claude F ranceschi. Mean follow-up length was 30 months. METHODS. Fifty-five co nsecutive 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 selec ted applying some exclusion criteria that emerged in the first part of the study. This second series was operated on by means of intraoperat ive angioscopy. The same preoperative evaluations have been used to st udy the outcome in all patients. RESULTS. CHIVA failed in the short sa phenous vein territory varices and when the long saphenous vein and th e insufficient perforating veins had a preoperative diameter greater t han 10 and 4 mm, respectively. The procedure showed a long saphenous v ein patency of 90.4% and registered a total recurrence rate of 18.7%. CONCLUSIONS. CHIVA seems to be a move effective varicose vein treatmen t than high ligation and distal stab avulsion. It also preserves a hig her rate of long saphenous veins, suitable for bypass surgery.