CHIVA method is a type of surgery used to treat

varicose veins Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. These veins typically develop in the legs, just under the skin. Varicose veins usually cause few symptoms. However, some indiv ...

that occur as a result of long term venous insufficiency. The term is a French acronym for Conservatrice Hémodynamique de l'Insuffisance Veineuse en Ambulatoire (ambulatory conservative hemodynamic treatment venous insufficiency). The method is based on the assumption that the symptoms of varicose veins are mainly the expression of an hemodynamic circulatory disorder, induced by various venous system malfunctions. CHIVA attempts to improve symptoms and signs without destroying the veins. __TOC__

Procedure

CHIVA involves

Doppler ultrasonography Doppler ultrasonography is medical ultrasonography that employs the Doppler effect to perform imaging of the movement of tissues and body fluids (usually blood), and their relative velocity to the probe. By calculating the frequency shift of ...

to assess the

hemodynamics Hemodynamics or haemodynamics are the dynamics of blood flow. The circulatory system is controlled by homeostatic mechanisms of autoregulation, just as hydraulic circuits are controlled by control systems. The hemodynamic response continuously ...

. Specifically the ultrasound study is to figure out where in the venous system the reflux begins. Then an operation is performed under local anesthesia, consisting of a few incisions and tying off of veins (usually one to four), without venous ablation. The ties are placed according to the ultrasound mapping. Areas where the veins are varicose may also be removed.

Clinical trials

One study found that with CHIVA, recurrences was 18% rather than 35% with high ligation and stripping after 10 years follow-up. Patient symptoms at 10 years, however, did not differ. The CHIVA and the stripping methods are equivalent regarding recurrence of varicose veins, but the CHIVA method may slightly reduce nerve injury and hematoma. The CHIVA method is also equivalent to either radio frequency ablation or endovenous laser therapy regarding recurrence and side effects.

References

{{reflist Vascular procedures