The CHIVA strategy applied to large-diameter saphenous veins

Tenezaca-Sari, Xavier; García-Reyes, Marvin; Escribano-Ferrer, J.M.; Marrero, Carlos Ortiz; Bellmunt‐Montoya, Sergi

doi:10.23736/s0392-9590.22.04831-3

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…Several methods for preserving saphenous vein in large caliber veins have been introduced, further studies are needed to confirm the association between the venous diameter and recurrence. 18,19 The mean hospital stay was 2.23 ± 0.49 days for RFA, while that of the CHIVA group was 1.08 ± 2.47 days, which was significantly shorter (p < 0.001). There was no difference in the operating time or postoperative pain between the two groups, but there was a difference in the methods used for anesthesia.…”

Section: Discussionmentioning

confidence: 93%

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Comparison between radiofrequency ablation and CHIVA procedure in patients with varicose veins

et al. 2023

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Objective Conservatrice et Hémodynamique de l'Insuffisance Veineuse en Ambulatoire, the French acronym for CHIVA, is a strategy aimed to convert a venous reflux into a physiological drainage. We compared CHIVA with radiofrequency ablation and determined its possible advantages. Methods We retrospectively analyzed the clinical recurrence, ultrasound recurrence, quality of life scores, and complications. They were compared after propensity score matching. Results 212 limbs of 166 patients were included: 42 limbs underwent radiofrequency ablation and 170 limbs underwent CHIVA. The hospital stay was shorter in the CHIVA group. There was no difference in clinical, ultrasound recurrence, quality of life scores and complications between the two groups. The preoperative saphenous vein diameter was larger in the recurrence cases. Conclusions CHIVA showed comparable results to radiofrequency ablation. There was more ultrasound recurrence with larger vein diameters. The CHIVA appears to be a simple and more efficient treatment method when performed on select patients.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Comparison between radiofrequency ablation and CHIVA procedure in patients with varicose veins

et al. 2023

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“…In the world, many scholars have reported the efficacy of CHIVA technology. [21][22][23] However, compared with the classical HLS technology, which method is better is still controversial. Therefore, this time, through the form of meta-analysis, including a large number of studies, from the clinical effects, complications and other aspects of the 2 techniques for detailed analysis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy and safety of ultrasound-guided CHIVA and traditional HLS in the treatment of varicose veins of lower extremities – a meta-analysis

Pei,

Li,

Niu

et al. 2023

Medicine

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Objective: Systematic evaluation of the efficacy and safety of conservative hemodynamic cure for venous insufficiency (CHIVA) compared with high ligation and stripping (HLS) in the treatment of varicose veins of lower extremities. Methods: We conducted a systematic literature search and compared the randomized controlled trial and retrospective cohort study of CHIVA and HLS in the treatment of varicose veins of lower extremities in several databases, including China National Knowledge Infrastructure, Wanfang database, cqvip datebase, PubMed, Cochrane library and EMBASE, to identify articles that might meet the criteria. Meta-analysis was performed using Revman 5.3 and Stata 13.0 software. Results: This Meta-analysis included a total of 14 research articles. This meta-analysis shows that CHIVA requires shorter operation time than HLS [mean difference (MD) = −13.57, 95% confidence interval (CI) (−21.05, −6.10), P = .0004]. There is less blood loss with CHIVA surgery [MD = −21.72, 95% CI (−30.35, −13.09), P < .00001]. The number of incisions made by the CHIVA technique is less [MD = −3.67, 95% CI (−4.03, −3.31), P < .00001]. Patients who underwent CHIVA had a shorter hospital stay [MD = −3.40, 95% CI (−4.72, −2.09), P < .00001]. The relapse rate was lower after CHIVA [OR = 0.36, 95% CI (0.18, 0.70), P = .003]. In terms of postoperative complications, CHIVA has a lower total complication rate [MD = 0.26, 95% CI (0.15, 0.46), P < .00001]. The incidence of deep vein thrombosis was lower after CHIVA [MD = 0.23, 95% CI (0.06, 0.92), P = .04]. CHIVA has a lower incidence of sensory disturbance than HLS [OR = 0.39, 95% CI (0.25, 0.60), P < .0001]. CHIVA technique has less nerve injury rate than HLS [OR = 0.11, 95% CI (0.02, 0.62), P = .01]. The incidence of hematoma was lower after CHIVA [OR = 0.48, 95% CI (0.27, 0.87), P = .02]. Among other metrics, the comparison results of the 2 techniques were similar. Conclusion: By comparison, it is found that CHIVA has shorter operation time, less blood loss, and fewer surgical incisions. Patients who underwent CHIVA surgery had shorter hospital stays and lower relapse rates. In terms of complications, the incidence of total complications after CHIVA is lower, and the incidence of postoperative deep vein thrombosis, postoperative sensory, nerve injury, and postoperative hematoma is also lower than that of HLS.

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“…ASVAL (Ablation Sélective des Varices Sous Anesthésie Locale -Selective Varicose Vein Ablation under Local Anesthesia) proposes the multifocal ascending theory, and the pressure of the blood column, combined with the weakness of the vein wall, creates a varicose reservoir. [142][143][144][145][146][147][148] Recommendation 19…”

Section: Treatment Of Saphenous Veinsmentioning

confidence: 99%

Brazilian guidelines on chronic venous disease of the Brazilian Society of Angiology and Vascular Surgery

Kikuchi,

Nhuch,

Drummond

et al. 2023

J. vasc. bras.

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The Brazilian Society of Angiology and Vascular Surgery has set up a committee to provide new evidence-based recommendations for patient care associated with chronic venous insufficiency. Topics were divided in five groups: 1. Classification, 2. Diagnosis, 3. Conservative or non-invasive treatment, 4. Invasive treatment and 5. Treatment of small vessels. This last series is closely related to the activities of Brazilian angiologists and vascular surgeons, who are heavily involved in the treatment of small superficial veins. These guidelines are intended to assist in clinical decision-making for attending physicians and health managers. The decision to follow a guideline recommendation should be made by the responsible physician on a case-by-case basis taking into account the patient's specific condition, as well as local resources, regulations, laws, and clinical practice recommendations.

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The CHIVA strategy applied to large-diameter saphenous veins

Cited by 5 publications

References 9 publications

Comparison between radiofrequency ablation and CHIVA procedure in patients with varicose veins

Comparison between radiofrequency ablation and CHIVA procedure in patients with varicose veins

Comparison of the efficacy and safety of ultrasound-guided CHIVA and traditional HLS in the treatment of varicose veins of lower extremities – a meta-analysis

Brazilian guidelines on chronic venous disease of the Brazilian Society of Angiology and Vascular Surgery

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