Abstract

Designed as a saphenous preserving, ambulatory, and office-based procedure to treat varicose disease, CHIVA (cure Conservatrice et Hémodynamique de l'Insuffisance Veineuse en Ambulatoire) has been practiced by its proponents for more than three decades. The value of CHIVA has been proven in literature for its therapeutic effects and cost-effectiveness in the treatment of varicose disease including the most advanced cases. Numerous studies suggest that the dilated great saphenous vein (GSV) will return to its normal size and function physiologically following a CHIVA procedure. Moreover, CHIVA preserves saphenous substance for future bypass grafts as needed. Today, the treatment of varicose disease is most often accomplished by stripping or endovascular ablation of GSV. Meantime, reports show that the ablation of GSV is at an alarming level, posing a health threat to the public due to a lack of GSV availability during arterial bypass operations. All these mean that an emphasis on saphenous preserving concepts in varicose disease treatment is validated. Among those concepts, CHIVA is an effective alternative with low recurrence rates to common procedures considering the multiple anatomical variants of varicose disease. As long-term studies demonstrate the safety and advantages of CHIVA, its dissemination should be encouraged in the community of vascular surgeons.

Key words: Varicose disease, venous insufficiency, chiva, saphenous vein, doppler