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.