[Ambulatory and hemodynamic treatment of varicose veins (CHIVA cure). Revolution or regression]

Ambulatory Hemodynamic Treatment of Varicose veins (CHIVA), owing to duplex scan, is a come back to forgotten method of cutting and ligation of superficial veins which have for a long time given the proof of inefficiency. This method ignores the fundamental problems of venous insufficiency. The long dated superiority of this technic about venous preservation compared with other methods is not demonstrated. The analysis of recurrent varicose veins after surgical treatment shows that the main cause is an inadequate operative technique associated with the evolution of the basic wall failure. CHIVA-cure, starting from the opposite opinion is doing un unbelievable come back to staged ligation expecting better results. The high rate of superficial venous thrombosis and complementary acts on the residual varicose veins, only one year after the primitive surgery, don't augur well of the future.