CHIVA for dummies

Abstract

Background: Sparing the Great Saphenous Vein capital for possible arterial substitution and recurrence decrease may be an alternative to current ablation options for Varicose Veins treatment. Conservative surgery of varicose veins (CHIVA) was suggested in 1988 by Franceschi, by limited veins interruptions in strategic points. However, the method did not diffuse due to the need for high Duplex expertise to determine the procedure in every single patient.

Method: Evaluation of the literature regarding saphenous sparing, with special reference to CHIVA.

Result: It has been realized that basic Ultrasound expertise is sufficient for performing GSV conservation. Most of the time, only a few parameters are needed: a junction competence assessment and a re-entry perforator position.

Conclusion: For achieving the goal of saphenous conservative treatment, a limited phlebectomy and possible Junction interruption (crossotomy) may be a simplified solution.

Keywords: CHIVA; Duplex ultrasound; ambulatory phlebectomy; hemodynamic surgery; sapheno femoral junction.