CHIVA method for the treatment of chronic venous insufficiency

CHIVA method appears to reduce recurrence of varicose veins and produce less bruising and nerve damage than vein stripping in the treatment of chronic venous insufficiency.

The quality of evidence is downgraded by study limitations (lack of blinding).

Summary

A Cochrane review included 4 studies with a total of 796 subjects (70.5% women). Three studies compared the CHIVA method with vein stripping, and one study compared the CHIVA method with compression dressings in people with venous ulcers. The ambulatory conservative hemodynamic correction of venous insufficiency (CHIVA) method is a minimally invasive surgical technique to treat varicose veins. The aim of the CHIVA treatment is to eliminate the venous-venous shunts by disconnecting the escape points, preserving the saphenous vein and normal venous drainage of the superficial tissues of the limb.

The primary endpoint, clinical recurrence, pooled between studies over a follow-up of 3 to 10 years, showed more favorable results for the CHIVA method than for vein stripping (table ) or compression dressings (RR 0.23, 95% CI 0.06 to 0.96; NNTB 3, 95% CI 2 to 17; 1 study, n=47). However, no differences in clinical improvement or cosmetic results, as perceived by participants and investigators, were detected between groups. Quality of life was only assessed one study and the results favored the CHIVA method. The CHIVA method showed a lower percentage of bruising and nerve injuries than vein stripping.

Clinical comments

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Ədəbiyyat

1. Bellmunt-Montoya S, Escribano JM, Dilme J et al. CHIVA method for the treatment of chronic venous insufficiency. Cochrane Database Syst Rev 2015;(6):CD009648. .