CHIVA method

CHIVA method is a surgical technique used in the treatment of varicose veins. The acronym CHIVA stands for "Cure Conservatrice et Hémodynamique de l'Insuffisance Veineuse en Ambulatoire," which translates to "Conservative and Hemodynamic Treatment of Venous Insufficiency in Outpatients." This method is based on the principle of preserving the veins while correcting the hemodynamic abnormalities that cause varicose veins, thereby alleviating symptoms and preventing recurrence.

Overview

The CHIVA method is a minimally invasive surgical strategy that aims to reduce venous hypertension by interrupting the reflux pathways. Unlike traditional methods such as vein stripping, which involve removing the affected veins, CHIVA preserves vein integrity. This approach is based on a detailed preoperative ultrasound mapping of the venous system to identify the sites of reflux and the connections between the deep and superficial venous systems.

Indications

The CHIVA method is indicated for patients with symptomatic varicose veins, especially those who have venous reflux as confirmed by duplex ultrasound. It is suitable for patients seeking a less invasive option with a focus on preserving vein function and those who are concerned about the cosmetic appearance of their legs.

Procedure

The CHIVA method involves several key steps: 1. Preoperative Assessment: Detailed duplex ultrasound mapping of the venous system to identify reflux points and plan the intervention. 2. Surgical Technique: Under local anesthesia, small incisions are made to access the identified reflux points. The surgeon then performs selective ligations of the insufficient vein segments while preserving the main saphenous vein when possible. 3. Postoperative Care: Patients are encouraged to walk immediately after the procedure and can usually return to normal activities within a few days. Compression stockings are often recommended for a short period postoperatively.

Advantages

The CHIVA method offers several advantages over traditional varicose vein treatments: - Minimally invasive with a focus on preserving the vein - Reduced risk of nerve damage and postoperative complications - Shorter recovery time and immediate mobilization - Lower recurrence rates due to the preservation of venous function - Improved cosmetic outcomes

Risks and Complications

As with any surgical procedure, the CHIVA method carries some risks, though they are generally minimal. These may include: - Hematoma or bruising at the incision sites - Temporary numbness or tingling due to nerve irritation - Infection, though rare - Deep vein thrombosis, also rare

Conclusion

The CHIVA method represents a significant advancement in the treatment of varicose veins, offering a less invasive, vein-preserving option that addresses the underlying hemodynamic issues. With its focus on preserving venous function and improving cosmetic outcomes, it provides an effective alternative for patients seeking treatment for varicose veins.