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Deutsche Gesellschaft für CHIVA e.V.
Literatur und Studien

Varicose Vein Stripping vs Haemodynamic Correction (CHIVA)

S. Caran­dina · C. Mari · M. De Palma · M.G. Mar­cel­lino · C. Cisno · A. Legnaro · A. Liboni · P. Zam­boni


Vari­cose Vein Strip­ping vs Hae­mo­dy­na­mic Cor­rec­tion (CHIVA)








Objec­tives. To com­pare the long-term results of strip­ping vs. hae­mo­dy­na­mic cor­rec­tion (Ambu­la­tory Con­ser­va­tive Hae- mody­na­mic Manage­ment of Vari­cose Veins, CHIVA) in the tre­at­ment of super­fi­cial venous incom­pe­tence resul­ting in chro­nic venous disease (CVD).
Design. Ran­do­mi­sed com­pa­ra­tive trial.

Pati­ents. 150 pati­ents affec­ted by CVD, CEAP cli­ni­cal class 2e6, were ran­do­mi­sed to saphenous strip­ping or to CHIVA. Methods. The cli­ni­cal out­come was asses­sed by an inde­pen­dent obser­ver who recor­ded the Hobbs cli­ni­cal score for trea­ted limbs. A sub­jec­tive report of the out­come was pro­vi­ded by the pati­ents. Recur­rence of vari­ces was asses­sed by both cli­ni­cal exami­na­tion and duplex ultra­so­no­gra­phy.

Results. The mean follow-up was 10 years, 26 pati­ents were lost to follow-up. The Hobbs score simi­lar in the strip­ping and CHIVA groups. Howe­ver recur­rence of vari­cose veins was signi­fi­cantly higher in the strip­ping group (CHIVA 18%; strip- ping 35%, P<0.04 Fisher’s exact test), without signi­fi­cant dif­fe­ren­ces in the rate of recur­ren­ces from the sapheno-femo­ral junc­tion. The asso­cia­ted risk of recur­rence at ten years was dou­bled in the strip­ping group (OR 2.2, 95% CI 1e5, P 1⁄4 0.04).

Con­clu­si­ons. Recur­rent vari­ces occur­red more fre­quently fol­lo­wing saphenous strip­ping than after CHIVA tre­at­ment. The deli­be­rate pre­ser­va­tion of the saphenous trunk as a route of venous drai­nage in the CHIVA group may have been a factor redu­cing the recur­rence rate.