Varicose vein stripping vs haemodynamic correction (CHIVA): a long term randomised trial

Related Experiment Video

Updated: Jul 10, 2026

Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
08:05

Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane

Published on: December 9, 2022

S Carandina1, C Mari, M De Palma

  • 1Department of Surgical, Anaesthesiological, and Radiological Sciences, Day-Surgery Unit, Vascular Diseases Center, University of Ferrara, Italy.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|October 30, 2007
PubMed

Insights

Saphenous stripping resulted in higher varicose vein recurrence rates compared to Ambulatory Conservative Haemodynamic Management of Varicose Veins (CHIVA) over ten years. CHIVA preserves venous drainage, potentially reducing recurrence in chronic venous disease.

Area of Science:

  • Vascular Surgery
  • Phlebology
  • Medical Technology Assessment

Background:

  • Superficial venous incompetence leads to chronic venous disease (CVD).
  • Traditional saphenous vein stripping is a common treatment for CVD.
  • Alternative minimally invasive techniques are being explored to improve long-term outcomes.

Purpose of the Study:

  • To compare the long-term efficacy of saphenous vein stripping versus CHIVA.
  • To evaluate recurrence rates and clinical outcomes in patients with CVD.
  • To assess the impact of treatment on superficial venous incompetence.

Main Methods:

  • A randomized comparative trial involving 150 patients with CVD (CEAP class 2-6).
  • Patients were randomized to either saphenous stripping or CHIVA treatment.
  • Clinical outcomes (Hobbs score), subjective patient reports, and recurrence (clinical/ultrasound) were assessed over a mean 10-year follow-up.

Main Results:

  • No significant difference in the Hobbs clinical score between stripping and CHIVA groups.
  • Varicose vein recurrence was significantly higher in the stripping group (35%) compared to CHIVA (18%, P<0.04).
  • The risk of recurrence at ten years was doubled in the stripping group (OR 2.2).

Conclusions:

  • Saphenous stripping leads to a higher frequency of recurrent varicose veins compared to CHIVA.
  • CHIVA treatment, by preserving the saphenous trunk for venous drainage, may reduce recurrence rates.
  • CHIVA represents a potentially more effective long-term treatment strategy for superficial venous incompetence.
Abstract

More Related Videos

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg09:04

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg

Published on: November 19, 2019

Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles03:06

Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles

Published on: December 22, 2023

Related Concept Videos

Varicose Veins II: Diagnostic Studies and Interprofessional Care01:26

Varicose Veins II: Diagnostic Studies and Interprofessional Care

Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Varicose Veins I: Introduction01:26

Varicose Veins I: Introduction

Varicose veins, or varicosities, are abnormally dilated and twisted superficial veins caused by venous valve incompetence. This condition commonly affects the lower extremities, especially the saphenous veins, due to the higher pressure from prolonged standing and walking. However, varicosities can also occur in other areas, such as the esophagus, vulva, spermatic cords, and anorectal region.Etiology and typesPrimary varicose veins, often idiopathic, are more common in women due to inherent...
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...